Orthopaedic implant stem component, joint component, and associated kit

ABSTRACT

A stem component having a body portion and a connection portion is provided. A portion of the stem component may be fitted to a cavity in a canal of a long bone. The stem component includes a canal portion and a sleeve portion that has an internal periphery that forms an internal cavity. A portion of the external periphery of the sleeve portion may be fitted to the cavity of the long bone. A portion of the external periphery of the connection portion may be fitted into the internal cavity of the sleeve portion, so that the external periphery of the connection portion of the joint component is spaced inwardly from the external periphery of the sleeve portion of the stem component when the joint component is fixedly connected to the stem component so that the joint component may be removed without disturbing the fixation to the long bone.

CROSS-REFERENCE TO RELATED APPLICATIONS

Cross-reference is made to the following applications: DEP5419USNPtitled “ORTHOPAEDIC IMPLANT, STEM AND ASSOCIATED METHOD” and DEP5563USNPtitled “ORTHOPAEDIC IMPLANT KIT, ORTHOPAEDIC SURGERY KIT AND ASSOCIATEDMETHOD” filed concurrently herewith which are incorporated herein byreference.

TECHNICAL FIELD OF THE INVENTION

The present invention relates generally to the field of orthopaedics,and more particularly, to an implant for use in arthroplasty.

BACKGROUND OF THE INVENTION

Patients who suffer from the pain and immobility caused byosteoarthritis and rheumatoid arthritis have an option of jointreplacement surgery. Joint replacement surgery is quite common andenables many individuals to function properly when it would not beotherwise possible to do so. Artificial joints are usually comprised ofmetal, ceramic and/or plastic components that are fixed to existingbone.

Such joint replacement surgery is otherwise known as joint arthroplasty.Joint arthroplasty is a well-known surgical procedure by which adiseased and/or damaged joint is replaced with a prosthetic joint. In atypical total joint arthroplasty, the ends or distal portions of thebones adjacent to the joint are resected or a portion of the distal partof the bone is removed and the artificial joint is secured thereto.

There are known to exist many designs and methods for manufacturingimplantable articles, such as bone prostheses. Such bone prosthesesinclude components of artificial joints such as elbows, hips, knees andshoulders.

Currently in total hip arthroplasty, a major critical concern is theinstability of the joint. Instability is associated with dislocation.Dislocation is particularly a problem in total hip arthroplasty.

Factors related to dislocation include surgical technique, implantdesign, implant positioning and patient related factors. In total hiparthroplasty, implant systems address this concern by offering a seriesof products with a range of lateral offsets, neck offsets, head offsetsand leg lengths. The combination of these four factors affects thelaxity of the soft tissue. By optimizing the biomechanics, the surgeoncan provide a patient a stable hip much more resistant to dislocation.In order to accommodate the range of patient arthropometrics, a widerange of hip implant geometries are currently manufactured by DePuyOrthopaedics, Inc., the assignee of the current application, and byother companies. In particular, the S-ROM® total hip systems offered byDePuy Orthopaedics, Inc. include three offsets, three neck lengths, fourhead lengths and one leg length adjustment. The combination of all thesebiomechanic options is rather complex.

Anteversion of a total hip system is closely linked to the stability ofthe joint. Improper version can lead to dislocation and patientdissatisfaction. Version control is important in all hip stems. However,it is a more challenging issue with the advent of stems with additionalmodularity.

The prior art has provided for some addressing of the anteversionproblem. For example, the current S-ROM® stems have laser markings onthe medial stem and the proximal sleeve. This marking enables thesurgeon to measure relative alignment between these components. Sincethe sleeve has infinite anteversion, it is not necessarily orientedrelative to a bony landmark that can be used to define anteversion. Infact, the current sleeves are sometimes oriented with the spout pointingdirectly laterally into the remaining available bone.

Prior art stems may be aligned relative to a patient's bony landmarks.These stems are monolithic. They cannot locate the neck independently ofthe distal stem. Therefore, anteversion is limited. Most bowed,monolithic stems are sold in fixed anteversion; for example, at ananteversion of 15 degrees. These monolithic stems have limitedflexibility for rotational alignment since the distal stem must followthe bow of the patient's femur and this may not provide an operablebiomechanical result.

In a common step in the surgical procedure known as total hiparthroplasty, a trial or substitute stem is first implanted into thepatient. The trial is utilized to verify the selected size and shape ofthe implant in situ on the patient and the patient is subjected to whatis known as a trial reduction. This trial reduction represents movingthe joint, including the trial implant through selected typical motionsfor that joint. Current hip instruments provide a series of trials ofdifferent sizes to help the surgeon assess the fit and position of theimplant. Trials, which are also known as provisionals, allow the surgeonto perform a trial reduction to assess the suitability of the implantand implant's stability prior to final implant selection.

Most hip stems implanted currently are of a one-piece or mono-blockdesign. Mono-block hip stem designs allow for no adjustments. Thus, theyrequire that the hip stem be removed and replaced to adjust head heightor offset. Also, mono-block stems are not designed to be used inminimally invasive surgery and are not optimal for use with minimallyinvasive surgery procedures.

Surgical variables such as leg length discrepancy may result in surgicalerror that may need to be corrected or optimized. Further, due toimplant subsidence during the use of an implant, the head-height at arevision surgery may need to be corrected. Further, revision surgery maybe required to correct the instability of the hip joint. Stability maybe restored by moving the head proximally and or increasing the offsetof the implant to tighten the soft tissues. These corrections may bemade at revision surgery to address these dislocations, however withcurrent mono-block stems the stem must be removed from the femur toaccomplish these changes in the implant configuration. Such removal ofthe stem from the femur may make the revision surgery quite difficult inthat the stem tends to engrow with the tissues of the bone. Also,removal of the stem may lead to significant loss of bone, which cancompromise the fixation of the stem upon re-implantation.

Further revision surgery may be required to correct weak abductorfunction by increasing the offset of the stem. The changing in arevision surgery to an increased offset stem may require that the stembe removed from the medullary canal of the femur and replaced with astem with a different offset.

Further mono-block stems are not easily used in minimally invasive hipprocedures where the incision through the skin and soft tissue isminimized. The surgeon may have difficulty to work in the joint spaceafter the stem is in place. The neck of the mono-block stem may be inthe way during the performance of the surgery.

In order to reduce inventory costs and complexity, many trialing systemsare modular. For example, in the Excel Instrument System, a product ofDePuy Orthopaedics, Inc., there is a series of broaches and neck trialsthat can be mixed and matched to represent the full range of implants.There is a single fixed relationship between a broach and a neck trial,because these trials represent a system of monolithic stem implants.

Likewise, in the current S-ROM® instrument systems provided by DePuyOrthopaedics, Inc., there are neck, proximal body, distal stem, head andsleeve trials. By combining all these components, the implant isrepresented. Since the S-ROM® stem is modular and includes a stem and asleeve, the angular relationship or relative anteversion between theneck and the sleeve is independent and represented by teeth matingbetween the neck and the proximal body trial. The proximal body trialhas fixed transverse bolts that are keyed to the sleeve in the trialingfor straight, primary stems. The long stem trials do not have thetransverse bolts and are thus not rotationally stable during trialreduction and therefore are not always used by the surgeon.

Prosthetic joint implants are currently surging in use and technology.In performing most prosthetic joint implants, what is known as a ‘trial’or ‘provisional’ is used before a final prosthesis is used. The trial orprovisional is used to select the proper joint prosthesis and/or toorient or align one or more of the components of the final jointprosthesis. The trial or trial components are temporarily implanted toachieve proper sizing, placement and/or orientation of the final jointprosthesis, as well as achieve anatomical orientation of the prosthesisand/or components of the joint prosthesis.

Hip arthroplasty provisionals or trials have a neck that is used toattach a femoral head provisional or trial thereto. The orientation ofthe neck relative to the shaft of the broach or trial is described interms of anteversion, neck length, neck angle, and/or neck offset.Because each patient's original femoral neck anatomy is different, theability to replicate the original femoral neck anatomy of each patientduring hip arthroplasty requires multiple neck trials having variousorientations. The use of multiple neck segments is not advantageoussince it requires more time, increased instrument cost and increasedspace in the instrument sterilization case.

Thus, trialing systems utilized by many hip implants or prosthesesgenerally consist of a broach and a neck segment. In order tointraoperatively change the offset of the trial (i.e. neck segment andbroach), the neck trial must be removed and another neck trial must beput in its place. Thus, multiple neck trials that are exchangeable withone another relative to the broach are necessary in order to replicatethe original hip anatomy.

Other hip systems utilize only one neck segment with the offsetincorporated into the location of the trunnion of the broach. Thisdesign, however, does not mimic the exact geometry of the actualimplant. While it is desired to be able to try several neck offsetsrelative to the broach in order to achieve a proper head positioning forthe final implant, the prior art is deficient.

In U.S. Pat. No. 5,645,607 issued to Hickey, a hip trial or prosthesishaving an adjustable neck portion is disclosed in which the problem ofmultiple neck trials is addressed. The adjustable neck of Hickey allowsthe trialing of various neck offsets in order to achieve acorrespondence between the spatial orientation of a patient's originalanatomy and a final implanted hip ball prosthesis.

However, Hickey requires a vertical height change of the neck segment inorder to move between the various offsets. Where vertical height isrestricted during surgery, especially in current, less invasivearthroplasty procedures, vertical height adjustment is undesirable.

There are a variety of modular stem designs in the prior art. Most ofthese designs focus on the ability to use varying stem diameters andlength with various size proximal bodies to provide optimal fill on boththe diaphysis and the metaphysis simultaneously (to optimize fixation ofthe device). In many of these designs the neck cannot be removed orreplaced to adjust head-height or offset without disturbing the fixationof at least the modular proximal body portion of the stem. Prior artmodular stems include the modular stem as disclosed in U.S. Pat. No.5,370,706 to Bolesky, et al. and assigned to the applicant of theinstant application. The Bolesky patent, U.S. Pat. No. 5,370,706 ishereby incorporated in its entirety by reference.

Another modular stem available in the prior art is the S-ROM® stem soldby DePuy Orthopaedics, Inc., Warsaw, Ind. and described in U.S. Pat.Nos. 4,624,673, 4,790,852, and 4,846,839. The U.S. Pat. Nos. 4,624,673,4,790,852, and 4,846,839 are incorporated herein by reference in theirentireties.

The prior art further includes a modular stem marketed by WrightMedical, Inc. of Arlington, Tenn. The Pro-Femur Stem provides a modularneck with a taper on both ends, one to engage the stem proximal body andone to engage the head.

The present invention is adapted to solve at least some of theaforementioned problems with the prior art.

SUMMARY OF THE INVENTION

An aspect of the present invention is in the form of a hip stem thatutilizes a modular neck portion. The hip stem includes two main parts.These parts are a hip stem body and a modular neck portion. The modularneck provides the surgeon the ability to adjust the proximal-distal headheight and the head offset. These adjustments may be either independentor in combination with each other. The adjustment can be made after thestem is seated and fixed into place, eliminating the need to disturb thefixation of the stem. The adjustment can take place as fine tuning atthe end of the initial orthopaedic surgery or upon a revision surgerywhen it is determined that the cause for the revision (such asinstability or leg length discrepancy) may be addressed by adjustment.

The design of an aspect of the present invention allows the stem body tobe implanted separately from the modular neck portion. This feature maybe advantageous in minimally invasive surgery where smaller componentsmay be easier to place through smaller incisions and where waiting untilnear the end of the operation to implant the neck portion provides moreroom for the surgeon to work and better access to the joint space.

According to yet another aspect of the present invention, the hip stemdesign includes two main parts, a hip stem body and a modular neckportion. The modular neck portion fits within a recess in the top of thestem body. This modular design allows the modular neck portion to beplaced or removed without disturbing the fixation of the stem body inthe bone. A variety of methods can be used to obtain mechanicalattachment of the modular stem portion to the body.

For example, in one embodiment of the present invention, dowel pins arepressed into one side of the interface with a tight slip fit on theother side to align and aid in carrying bending moments across theinterface. This design ensures that the screw (which is used to applythe compressive locking forces across the interface) is subjected onlyto axial tension loads. By eliminating bending moments in the screw,fatigue failure of the thread fastener can be better avoided.

According to another aspect of the present invention, a means forholding the screw captive in the modular stem portion may be desirableto aid in assembling the modular stem portion to the stem body. Suchcapture of the screw would minimize the number of parts to be handledand eliminate the need to handle or assemble many small pieces.

In yet another embodiment of the present invention, the dowel pins arereplaced with tapers, which may be either rectangular or cylindrical.The tapers serve to align the parts and carry any bending moments sothat the screw is subjected to only axial tension loads.

In yet another aspect, the present invention provides a hip stem for usein performing hip arthroplasty. The hip stem is to be fitted to a cavityin the canal of a femur. The hip stem includes a stem componentincluding a distal stem portion and a proximal body portion. The hipstem also includes a neck component fixedly connectable to the stemcomponent. The neck component includes a proximal neck portion and adistal body portion. The neck component is adapted for removal from thefemur without disturbing the fixation of the stem component to the bone.

In another aspect, the present invention provides a hip prosthesis foruse in performing hip arthroplasty. The hip stem is fitted to a cavityin the canal of a femur. The hip prosthesis includes an acetabular cup,a head, a neck component and a stem component. The stem componentincludes a distal stem portion and a proximal body portion. The neckcomponent is fixedly connectable to the stem component. The neckcomponent includes a proximal neck portion and a distal body portion.The neck component is adapted for removal from the femur withoutdisturbing the fixation of the stem component to the bone.

In another aspect, the present invention provides a kit for performingrevision surgery. The kit includes a stem component having a distal stemportion and a proximal body portion. The kit also includes a first neckcomponent fixedly connectable to the stem component. The first neckcomponent includes a proximal neck portion and a distal body portion.The first neck component is adapted for removal from the femur withoutdisturbing the fixation of the stem component to the bone. The kit alsoincludes a second neck component fixedly connectable to the stemcomponent. The second neck component includes a proximal neck portionand a distal body portion. The second neck component is adapted forremoval from the femur without disturbing the fixation of bonesurrounding the stem component.

In another aspect, the present invention provides an orthopaedic implantfor use in performing joint arthroplasty. A portion of the orthopaedicimplant is to be fitted to a cavity in the canal of a long bone. Theorthopaedic implant includes a stem component having a stem portion anda body portion. The orthopaedic implant also includes a joint componentfixedly connectable to the stem component. The joint component has anarticulation portion and a connection portion. The joint component isadapted for removal from the long bone without disturbing the fixationof bone surrounding the stem.

In another aspect, the present invention provides a stem component foruse with a joint component having an articulation portion and aconnection portion in performing joint arthroplasty. At least a portionof the stem component is to be fitted to a cavity in the canal of a longbone. The stem component includes a stem portion and a body portion. Thebody portion is adapted to permit removal of the connection portion ofthe joint component from the long bone without disturbing the fixationof bone surrounding the joint component.

In another aspect, the present invention provides a joint component foruse with a stem component having a body portion and a stem portion inperforming joint arthroplasty. At least a portion of the stem componentis to be fitted to a cavity in the canal of a long bone. The jointcomponent includes a connection portion and an articulation portion. Theconnection portion is adapted to permit the removal of the jointcomponent from the long bone without disturbing the fixation of bonesurrounding the joint component.

In another aspect, the present invention provides an orthopaedic implanttrial for use in performing joint arthroplasty and to assist inperforming a trial reduction in performing joint arthroplasty. A portionof the orthopaedic implant trial is fitted to a cavity in the canal of along bone. The orthopaedic implant trial includes a stem componenthaving a stem portion and a body portion. The orthopaedic implant trialalso includes a joint component fixedly connectable to the stemcomponent. The joint component has an articulation portion and aconnection portion. A portion of the body portion of the stem componentextends over a portion of the connection portion of the joint component.

In another aspect, the present invention provides a kit for use inperforming joint arthroplasty. The kit includes an orthopaedic implanttrial for use in performing joint arthroplasty. The trial is to befitted to a cavity in the canal of a long bone and to assist inperforming a trial reduction in performing joint arthroplasty. Theorthopaedic implant trial includes a stem component having a stemportion and a body portion. The orthopaedic implant trial also includesa joint component fixedly connectable to the stem component. The jointcomponent has an articulation portion and a connection portion. Thejoint component is adapted for removal from the long bone withoutdisturbing the fixation of the stem component to the bone. The kitincludes an orthopaedic implant for use in performing jointarthroplasty. A portion of the orthopaedic implant is fitted to a cavityin the canal of a long bone. The orthopaedic implant includes a stemcomponent having a stem portion and a body portion. The orthopaedicimplant also includes a joint component fixedly connectable to the stemcomponent. The joint component includes an articulation portion and aconnection portion. The joint component is adapted for removal from thelong bone without disturbing the fixation of bone surrounding the jointcomponent.

In another aspect, the present invention provides a method for treatingorthopaedic joint disease of a patient. The method includes the step ofimplanting an orthopaedic implant into a cavity in the canal of a longbone. The orthopaedic implant includes a stem component and a firstjoint component fixedly connectable to the stem component. The jointcomponent is adapted for removal from the long bone without disturbingthe fixation of the stem component to the bone. The method also includesthe steps of monitoring the condition of the patient and determiningthat the patient needs a revision prosthesis. The method also includesthe steps of providing a second joint component compatible with the stemcomponent and removing the first joint component from the stem componentof the orthopaedic implant in vivo in the patient without disturbing thefixation of bone surrounding the orthopaedic implant. The method alsoincludes the step of implanting the second joint component into the stemcomponent in vivo in the patient.

In another aspect, the present invention provides a method for providingrevision joint arthroplasty on a patient having an orthopaedic implant.The orthopaedic implant includes a stem component and a first jointcomponent fixedly connectable to the stem component. The joint componentis adapted for removal from the long bone without disturbing thefixation of the stem component to the bone. The method includes thesteps of monitoring the condition of the patient and determining thatthe patient needs a revision prosthesis. The method also includes thesteps of providing a second joint component compatible with the stemcomponent and removing the first joint component from the stem componentof the orthopaedic implant in vivo in the patient without disturbing thefixation of bone surrounding the orthopaedic implant. The method alsoincludes the step of implanting the second joint component into the stemcomponent in vivo in the patient.

In another aspect of the present invention an orthopaedic implant foruse in performing joint arthroplasty is provided. A portion of theimplant is fitted to a cavity in the canal of a long bone. The cavityextends from a resected plane of the long bone. The implant includes ajoint component having a stem element with an external periphery. Thestem element defines a distal end for insertion into the cavity. Theexternal periphery of the stem element has a resection ring that alignswith the resected plane of the long bone and a body element fixedlyconnectable to the stem element. The body element has a externalperiphery. A distal portion of the body element extends from theresection ring toward the distal end of the stem element. The peripheryof the body element is spaced from the external periphery of the stemelement so that the body element may be removed without disturbing thefixation.

According to yet another aspect of the present invention an orthopaedicimplant stem for use in performing joint arthroplasty is provided. Aportion of the orthopaedic implant stem is to be fitted to a cavity inthe canal of a long bone. The orthopaedic implant stem includes a distalelement defining an external periphery of the distal element. The distalelement defines a distal end of the element for insertion into thecavity and an opposed connection end. The distal element defines arecess therein extending from the opposed connection end of the distalelement. The orthopaedic implant stem component also includes a proximalelement fixedly connectable to the distal element. A distal portion ofthe proximal element extends generally from the connection end of thedistal element toward the distal end of the distal element when theproximal element is fixedly connected to the stem. The distal portion ofthe proximal element is spaced inwardly from the external periphery ofthe distal element when the proximal element is fixedly connected to thestem component so that the proximal element may be removed from the longbone without disturbing the fixation of the distal element to the longbone.

According to another aspect of the present invention a method fortreating orthopaedic joint disease of a patient is provided. The methodincludes the steps of resecting a long bone along a resection plane andpreparing a cavity in the canal of the long bone. The method includesthe step of implanting an orthopaedic implant into a cavity in the canalof a long bone. The orthopaedic implant includes a joint componenthaving a stem element and a first body element fixedly connectable tothe stem element. The orthopaedic implant is secured in the canal of thelong bone with the body element being spaced from the long bone. Themethod further includes the steps of monitoring the condition of thepatient, determining that the patient needs a revision prosthesis,providing a second body element compatible with the stem element, andremoving the first body element from the stem element of the orthopaedicimplant in vivo in the patient without disturbing the fixation of bonesurrounding the stem element of the orthopaedic implant and withoutdamaging bone surrounding the first body element. The method alsoincludes the step of implanting the second body element into the stemelement in vivo in the patient.

According to yet another aspect of the present invention an orthopaedicimplant for use in performing joint arthroplasty is provided. A portionof the orthopaedic implant is capable of being fitted to a cavity in thecanal of a long bone. The cavity extends from a resected plane of thelong bone. The orthopaedic implant includes a joint component. The jointcomponent includes a stem element defining an external periphery of thestem element. The stem element has a first end for insertion into thecavity. The external periphery of the stem element has a stem resectionring. The stem resection ring may be aligned with the resected plane ofthe long bone. The joint component also includes a body element, whichis capable of being fixedly fitted to the stem element. The body elementincludes an external periphery. The external periphery of the bodyelement has a body resection ring. The body resection ring may bealigned with the resected plane of the long bone. A canal portion of thebody element extends generally from the resection ring of the externalperiphery of the body element toward the first end of the stem elementwhen the body element is fixedly connected to the stem element. Theexternal periphery of the canal portion of the body element is spacedinwardly from the external periphery of the stem element when the bodyelement is fixedly connected to the stem so that the body element may beremoved from the long bone without disturbing the fixation of the stemelement to the long bone.

According to a further aspect of the present invention an orthopaedicimplant stem for use in performing joint arthroplasty is provided. Aportion of the orthopaedic implant stem may be fitted to a cavity in thecanal of a long bone. The orthopaedic implant stem includes a canalelement having an external periphery. The canal element has a first endfor insertion into the cavity and an opposed connection end. The canalelement has a recess extending from the opposed connection end of thecanal element. The recess has a internal periphery. The canal elementalso has an external periphery spaced outwardly from the internalperiphery of the recess. The orthopaedic implant stem further includes abody element that may be fixedly connected to the canal element. A firstportion of the body element may be inserted into the recess of the canalelement when the first element is fixedly connected to the canalelement. The first portion of the body element is spaced inwardly fromthe external periphery of the canal element when the body element isfixedly connected to the canal element so that the body element may beremoved from the long bone without disturbing the fixation of the canalelement to the long bone.

According to a another aspect of the present invention a method fortreating orthopaedic joint disease of a patient is provided. The methodincludes the steps of resecting a long bone along a resection plane andpreparing a cavity in the canal of the long bone. The method alsoincludes the step of implanting an orthopaedic implant into a cavity inthe canal of the long bone. The orthopaedic implant includes a jointcomponent having a canal element and a first body element. The firstbody element may be fixedly connected to the canal element. Theorthopaedic implant is secured in the canal of the long bone with thefirst body element being spaced from the long bone. The method furtherincludes the steps of monitoring the condition of the patient anddetermining that the patient needs a revision prosthesis. The methodalso includes the steps of providing a second body element connectableto the canal element and removing the first body element from the canalelement of the orthopaedic implant in vivo without disturbing thefixation of bone surrounding the canal element of the orthopaedicimplant and without damaging bone surrounding the first body element.The method further includes the step of implanting the second bodyelement into the canal element in vivo.

The technical advantages of the present invention include the ability toindependently adjust the head-height and the head offset withoutdisturbing the fixation of the stem in the bone. For example, accordingto one aspect of the present invention a hip stem is provided includinga stem component including a distal stem portion and a proximal bodyportion and a neck component. The neck component is fixably connected tothe stem component. The neck component includes a proximal neck portionand a distal body portion. The neck component is adapted for removalfrom the femur without disturbing the fixation of the stem component tothe bone. Thus, the present invention provides for the ability toindependently adjust the head-height and the head offset withoutdisturbing the fixation in the stem of the stem in the bone by merelychanging the neck component by removing the neck component from the stemcomponent while the stem component is in position in the bone.

The technical advantages of the present invention further include theability to enhance minimally invasive hip procedures by having smallerincisions for the stem and neck. For example, according to anotheraspect of the present invention, a hip stem is provided including a stemcomponent having a distal stem component and a proximal body portion anda neck component. The neck component is fixably connectable to the stemcomponent. The neck component includes a proximal neck portion and adistal body portion. The neck component is adapted for removal from thefemur without disturbing the fixation of the stem component to the bone.The stem component may thus be first inserted into the incision, put inposition and then the neck component may be secured to the stemcomponent. Thus the present invention provides for the enhancing ofminimally invasive hip procedures by having smaller incisions for thestem and body. By allowing the neck portion to be inserted separatelyfrom the stem body, the implants may be inserted through a smallerincision with reduced soft tissue stretching and allowing the surgeonmore space to work within the joint space until later in the procedurewhen the neck portion is inserted. In other words, the stem may bepositioned in the incision and through the soft tissue put in place inthe canal of the long bone and, in fact, cemented into position andpermitted to be fixably secured into the proper position. At that time,the neck portion may then be inserted through the incision and theprocedure continued.

The technical advantages of the present invention include the ability topermit common hip prostheses to be used for right and left hand versionsof the hip prosthesis. For example, according to yet another aspect ofthe invention, a hip stem is provided with a stem component and a neckcomponent. At least one of the stem component and the neck component areadapted to permit the stem component and neck component to have a firstassembly relationship as well as a second assembly relationship which isdifferent than the first assembly relationship. Thus the presentinvention provides for a hip stem assembly that permits both right andleft hand versions with a common set of hip stem components.

The technical advantages of the present invention further include theability to correct surgical error or optimize the surgical variablessuch as leg length discrepancy. For example, according to yet anotheraspect of the present invention, a hip stem is provided including a hipstem component and a neck component. The neck component is adapted forremoval from the femur without disturbing the fixation of the stemcomponent to the bone. Thus, the present invention provides for thereplacement of the neck from the stem with the replacement neck having adifferent neck length than the replaced neck while replacing the neckwith the stem in place. Thus the present invention provides for thecorrection of surgical error or optimization of a surgical variable suchas leg length discrepancy.

The technical advantages of the present invention also include theability to correct head height at revision surgery due to implantsubsidence. For example, according to yet another aspect of the presentinvention, a hip stem is provided including a stem component and a neckcomponent. The neck component is adapted for removal from the femurwithout disturbing the fixation of the stem component to the bone. Thus,the present invention provides for a replacement of the neck componentwith a replacement neck component with a different head-height than theinitial neck component while having the stem component remain in placeon the bone. Thus, the present invention provides for a correction ofhead height at revision surgery to adjust for implant subsidence.

The technical advantages of the present invention include the ability tocorrect instability of the hip joint. Stability may be restored bymoving the head proximally and/or increasing the offset to tighten thesoft tissue. The corrections can also be made at revision surgery toaddress dislocations. For example, according to yet another aspect ofthe present invention, a hip stem is provided including a stem componentas well as a plurality of neck components. One of the pluralities ofneck components may have a first offset dimension and the secondcomponent have a greater offset dimension. Thus, the present inventionprovides for replacing the first neck component with a second neckcomponent with greater offset while having the stem remain in place onthe bone. Thus, the present invention provides for the correction ofinstability by moving the head proximally or increasing the offset totighten the soft tissues.

The technical advantages also include the ability to correct weakabductor function by increasing the offset of the hip stem, whichincreases the efficiency of the abductor muscles by increasing themoment arm of the abductor muscle action For example, according to yetanother aspect of the present invention, a hip stem is providedincluding a stem component and a first neck component having a firstoffset and a second neck component having a greater offset than thefirst neck component. The neck component is adapted for removal from thefemur without disturbing the fixation of the stem component to the bone.Thus, the present invention provides for replacing a first neckcomponent with a second neck component of greater offset while the stemis in place in the bone. Thus, the present invention provides forcorrection of weak abductor function by increasing the offset of the hipstem.

Other technical advantages of the present invention will be readilyapparent to one skilled in the art from the following figures,descriptions and claims.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present invention and theadvantages thereof, reference is now made to the following descriptiontaken in connection with the accompanying drawings, in which:

FIG. 1 is a plan view of a modular hip stem in accordance with anembodiment of the present invention utilizing a tapered lock and screw;

FIG. 1A is a partial plan view of an alternate embodiment of the presentinvention in the form of a modular hip stem with a tapered stemconnection and a modular neck;

FIG. 1B is a cross-sectional view of FIG. 1 along the line 1B-1B in thedirection of the arrows;

FIG. 2 is a top view of the modular hip stem of FIG. 1;

FIG. 3 is a plan view of a modular hip stem in accordance with anotherembodiment of the present invention utilizing dowel pins and a screw;

FIG. 3A is a partial plan view of an alternate embodiment of the presentinvention in the form of a modular hip stem with a pinned stemconnection and a modular neck;

FIG. 4 is a top view of the modular hip stem of FIG. 3;

FIG. 5 is a plan view of a kit for performing hip orthopaedic surgery inaccordance with yet another embodiment of the present invention;

FIG. 6 is a plan view of a second stem component of a modular hip stemfor use with the kit of FIG. 5;

FIG. 7 is a plan view of a neck component of a modular hip stem for usewith the kit of FIG. 5 including a through opening for utilizing a screwand having different offsets than the neck components of FIG. 5;

FIG. 8 is a plan view of a modular hip stem in accordance with anotherembodiment of the present invention utilizing dowel pins to provide fordifferent version with the same stem;

FIG. 9 is a plan view of a modular hip stem in accordance with yetanother embodiment of the present invention utilizing a rectangulartapered lock and a screw;

FIG. 9A is a cross-sectional view of FIG. 9 along the line 9A-9A in thedirection of the arrows;

FIG. 10 is a top view of the modular hip stem of FIG. 9;

FIG. 11 is an end view of the modular hip stem of FIG. 9;

FIG. 12 is a plan view of a modular hip stem in accordance with afurther embodiment of the present invention utilizing a tapered lock;

FIG. 13 is a plan view of a hip implant in accordance to anotherembodiment of the present invention including a modular hip stem similarto that of FIG. 3;

FIG. 14 is a top view of a modular hip stem with left handed proximalcomponent with a neck extending posteriorly and a distal component;

FIG. 15 is a top view of a modular hip stem with a right handed proximalcomponent with a neck extending posteriorly, utilizing the distalcomponent of the hip stem of FIG. 14;

FIG. 16 is a plan view of the modular hip stem of FIGS. 14 and 15;

FIG. 17 is a plan view of a modular stem in accordance with a furtherembodiment of the present invention in the form of a tibial trayassembly implanted in the tibia;

FIG. 18 is a plan view of a further embodiment of the modular stem ofthe present invention in the form of a modular shoulder prosthesisimplanted in the humerus and glenoid cavity;

FIG. 19 is a plan view of a kit for performing joint arthoplastyincluding the modular stem of the present invention;

FIG. 20 is a process flow diagram of a method of performing jointarthroplasty surgery in accordance with yet another embodiment of thepresent invention;

FIG. 21 is a process flow diagram for a method of performing jointarthroplasty surgery according to a further embodiment of the presentinvention;

FIG. 22 is a process flow diagram of a method of performing jointarthroplasty surgery in accordance with yet another embodiment of thepresent invention;

FIG. 23 is a process flow diagram for a method of performing jointarthroplasty surgery according to a further embodiment of the presentinvention;

FIG. 24 is a plan view of another kit for performing joint arthroplastyincluding the modular stem of the present invention;

FIG. 25 is a plan view of a modular hip stem in accordance with afurther embodiment of the present invention utilizing a location ring;

FIG. 26 is a plan view of a body component of a modular hip stem inaccordance with a further embodiment of the present invention utilizinga location ring; and

FIG. 27 is a plan view of yet another kit for performing jointarthroplasty including the modular stem of the present invention.

DETAILED DESCRIPTION OF THE INVENTION

Embodiments of the present invention and the advantages thereof are bestunderstood by referring to the following descriptions and drawings,wherein like numerals are used for like and corresponding parts of thedrawings.

According to the present invention and referring now to FIG. 1, anembodiment of the present invention is shown as hip stem 10. Hip stem 10is utilized for performing hip arthroplasty. The hip stem 10 is designedto be fitted into a cavity 2 in the canal 4 of a long bone 6, forexample, the femur. The hip stem 10 includes a stem component 12including a distal stem portion 14 and a proximal body portion 16. Thehip stem 10 further includes a neck component 18 which, is as shown inFIG. 1, is fixedly connectable to the stem component 12. The neckcomponent 18 includes a proximal neck portion 20 and a distal bodyportion 22. The neck component 18 is adapted for removal from the femur6 without disruption of bone 8 around the stem component 12.

To provide for the removal of the neck component without disturbing thefixation of the stem component 12 to the bone 8, the hip stem 10 of thepresent invention may be adapted to provide all the support for the hipstem and fixation of the hip stem 10 to the femur 6 with the stemcomponent 12. Thus, as shown in FIG. 1, the stem component 12 isconfigured, preferably, to provide as much support as possible for thehip stem 10 to the femur 6. For example, and as shown in FIG. 1, aportion 24 of the proximal body portion 16 of the stem component 12extends over a portion of the distal body portion 22 of the neckcomponent 18.

While the portion 24 of the proximal body portion of the stem component12 may be positioned anywhere around the femur 6 to provide additionalsupport for the stem component 12, it should be appreciated, andreferring to FIG. 1, the portion 24 may extend substantially around theperiphery of the femur 6.

For example, and as shown in FIG. 1, the stem component 12 may include asleeve portion 26 extending proximally from the proximal body portion 16of the stem component 12. The sleeve portion 26 may extend laterally,medially, anteriorly, or posteriorly or a combination thereof. Forexample, and as shown in FIG. 1, the sleeve portion 26 extendssubstantially around periphery 28 of the distal body portion 22 of theneck component 18.

As shown in FIG. 1, the distal body portion 22 of the neck component 18may receive the stem component 12. To accommodate the neck component 18,the proximal body portion 16 of the stem component 12 may define apocket 32 in the proximal body portion 16 for receiving the neckcomponent 18.

As shown in FIG. 1, the hip stem 10 may be configured to assist in theremoval of the neck component 18 from the femur 6 without disturbing thefixation of the stem component to the bone 8, the neck component 18 maybe spaced from the femur. By spacing the neck component 18 from thefemur, the neck component 18 may be removed without disturbing thefixation of the stem component 12 to the bone.

As shown in FIG. 1, the distal body portion 22 of the neck component 18is removably secured to the proximal body portion 16 of the stemcomponent 12. The distal body portion 22 and the proximal body portion16 may be removably secured to each other in any reasonable manner.

For example, and as shown in FIG. 1, the proximal body portion 16 of thestem component 12 includes a periphery 34 of the proximal body portion16. A portion 36 of the periphery 34 is generally planer. Similarly, thedistal body portion 22 of the neck component 18 defines a periphery 38of the distal body portion. A portion 40 of the periphery 38 isgenerally planer. The neck planer portion 40 and the body planer portion36 are in contact with each other. The contact of the neck planerportion 40 and the body planer portion 36 provide for a stable supportof the neck component 18 onto the stem component 12.

For simplicity and as shown in FIG. 1, the stem component 12 defines alongitudinal axis 42 of the stem component 12. For simplicity and toprovide for strength and rigidity, the neck planer portion 40 and thebody planer portion 36 are generally normal or perpendicular to thelongitudinal axis 42.

As shown in FIG. 1, the hip stem 10 may include a connector in the formof, for example a fastener, for example a screw 44 to connect the neckcomponent 18 to the stem component 12. As shown in FIG. 1, the connector44 may be in the form of, for example, a screw.

Neck component 18 may be connected to the stem component 12 in manydifferent ways within the various embodiments of the present invention.For example and as shown in FIG. 1, the distal body portion 22 of theneck component 18 may include a protrusion 46 extending downwardly fromthe neck planer portion 40. Protrusion 46 may have any suitable shape,and may as shown in FIG. 1 have a generally circular cross-section andbe tapered defining an included angle α. Stem component 12 may, in orderto receive the protrusion 46 of the neck component 18, define anaperture 48 formed in the proximal body portion 16 of the stem component12. Aperture 48 may have a contour matching that of the protrusion 46for receiving the protrusion therein. It should be appreciated that theangle α may be sufficiently small to provide for a soft self-lockingfeature between the protrusion 46 and the aperture 48.

For a self-locking taper the angle α should be defined by the formula;${Tan}\frac{\left( {\alpha/2} \right) < \mu}{2}$ whereμ = coefficient  of  friction α = included  angle

Referring now to FIG. 1-B, the protrusion 46 and the aperture 48 areshown in cross-section. As shown in FIG. 1-B, the protrusion 46 has acircular cross-section defined by protrusion diameter PD.

As shown in FIG. 1, the connector 44 may be in the form of a screw. Thescrew 44 may be any suitable screw and may, as shown in FIG. 1, have aflat head and be in the form of a socket-headed cap screw. Connector 44may be received by the neck component 18 by a connector opening 50formed in the neck component 18 and positioned about longitudinal axis42. The connector 44 may be received into the stem component 12 throughstem component aperture 52. The stem component aperture 52 may includeinternal threads 54 that mate with external threads 56 formed on theconnector or screw 44.

The hip stem 10 including the stem component 12, the neck component 18as well as the screw 44 may be made of any suitable durable material.For example, the stem component 12, the neck component 18 and theconnector 44 may be made of, for example, a metal, a plastic or acomposite. The materials from which the components of the hip stem 10are manufactured preferably are materials that are compatible with thehuman body. For example, if the stem component 12, neck component 18, orthe connector or screw 44 are made of a metal, the components may bemade of, for example, a cobalt chromium alloy, a stainless steel alloy,or a titanium alloy.

The stem component 12 may have any suitable shape capable of insertioninto the canal 4 of the femur 6. For example, the stem component 12 mayinclude a stem periphery 58 having a shape similar to that of the broachor rasp used to form the cavity 2 in the canal 4 of the long bone orfemur 6. The proximal body portion 16 of the stem component 12 may, asshown in FIG. 1, have a larger cross-section than that of the distalstem portion 14 to conform with the corresponding shape of the naturalfemur 6.

The neck component 18 of the hip stem 10 may have any suitable shapecapable of mating with the stem component 12 and capable of providingsupport for the ball or head 60 which may be placed on external taper 62formed on neck 64 of the neck component 18. It should be appreciatedthat the hip stem 10 may be integral with the neck component 18.

As shown in FIG. 1, hip stem or orthopaedic implant stem 10 is used forperforming joint arthroplasty. A portion of the orthopaedic implant stem10 may be fitted to cavity 2 in the canal 4 of long bone 6. Theorthopaedic implant stem 10 includes a stem component or canal element12 having external stem periphery 58. The canal element 12 has a firstend 15 for insertion into the cavity and an opposed connection end 17.The canal element 12 has pocket or recess 32 extending from opposedconnection end 17 of the canal element 12. The recess 32 has an internalperiphery 23. The canal element 12 also has external periphery 58 spacedoutwardly from the internal periphery 23 of the recess 32. Theorthopaedic implant stem 10 further includes neck component or bodyelement 18 that may be fixedly connected to the canal element 12. Distalbody portion or first distal body portion 22 of the neck component 18may be inserted into the recess 32 of the canal element 12 when the neckcomponent 18 is fixedly connected to the canal element 12. Externalperiphery 78 of the first portion 22 of the neck component 18 is spacedinwardly from the external periphery 58 of the canal element 12 when theneck component 18 is fixedly connected to the canal element 12 so thatthe neck component 18 may be removed from the long bone 6 withoutdisturbing the fixation of the canal element 12 to the long bone 6.

As shown in FIG. 1, the distal body portion 22 of the neck component 18may have any suitable shape and typically has a shape compatible forplacement within the recess or pocket 32 formed in the proximal bodyportion 16 of the stem component 12. For example, the distal bodyportion 22 may, as shown in FIG. 2, have a generally rectangular shapedefined by neck body width NBW and neck body length NBL.

Referring now to FIG. 1A, another embodiment of the present invention isshown as hip stem 10A. The hip stem 10A is similar to the hip stem 10 ofFIG. 1, except that the neck component 18A is of a modular constructionor is made from more than one piece. For example, as shown in FIG. 1A,the neck component 18A includes a distal body component 22A and aproximal neck component 20A. The proximal neck component 20A may besecured to the distal body component 22A in any suitable fashion.

As shown in FIG. 1A, the proximal neck component 20A includes anexternal taper 21A that mates with a cavity 23A formed in the distalbody component 22A. It should be appreciated that the components formingthe neck component 18A may be threadably attached, press-fit attached orhave a bayonet lock or any type of connector. The hip stem 10A furtherincludes a stem component 12A which is similar to the stem component 12and includes a distal stem portion 14A and a proximal body portion 16A.

Hip stem 10 of the present invention, as shown in FIG. 1 and FIG. 2, maybe utilized for both cemented and cementless hip arthroplasty. Forexample, the hip stem 10 may be used with a femur having a cavityprepared for cement with the cement being positioned between the femur 6and the hip stem 10. The cavity 2 of the femur 6 may alternatively beprepared such that the stem periphery 58 may directly connect with theperiphery of the cavity 2. It should be appreciated that whether the hipstem 10 uses cemented or cementless construction, the neck component 18may be removed from the stem component 12 without disruption of the boneimplant ingrowth.

According to the present invention and referring now to FIGS. 3 and 4,yet another embodiment of the present invention is shown as hip stem110. Hip stem 110 is similar to the hip stem 10 of FIGS. 1 and 2 andmay, in fact, be made of similar materials with generally similarshapes. The hip stem 110, however, is different from the hip stem 10 ofFIGS. 1 and 2.

For example and as shown in FIGS. 3 and 4, the hip stem 110 includes astem component 112 somewhat similar to the hip stem component 12 ofFIGS. 1 and 2. The hip stem 110 further includes a neck component 118somewhat similar to the neck component 18 of FIGS. 1 and 2. The hip stem110 further includes a connector 144 which is different than connector44 of the hip stem 10 of FIGS. 1 and 2.

For example, as shown in FIGS. 3 and 4, the connector 144 includes ascrew 164 similar to the screw 44 of the hip stem 10 of FIGS. 1 and 2.In addition to the screw 64, the connector 144 further includes a pin,for example, first pin 166. The hip stem 110, it should be appreciated,may be manufactured with a solitary pin 166 but may, as shown in FIGS. 3and 4, further include a second pin 168. The pins 166 and 168 as well asthe screw 164 serve to form the connector 144. The connector 144 is usedto connect the neck component 118 to the stem component 112.

The first pin 166 and the second pin 168 may, for simplicity as shown inFIGS. 3 and 4, be substantially the same. For example, the pins 166 and168 may be cylindrical. For example, the first pin 166 and the secondpin 168 may be defined by a pin diameter PD and a pin length PIL. Thefirst pin 166 and the second pin 168 may be made of any suitable durablematerial and may, for example, be made of a metal. If made of a metal,the first pin 166 and the second pin 168 may, for example, be made of amaterial compatible with a human body. For example, a cobalt chromiumalloy, a stainless steel alloy, or a titanium alloy.

The stem component 112 may, as is shown in FIGS. 3 and 4, have a distalstem portion 114 and a proximal body portion 116. Internal threads 156may be formed on proximal body portion 116 to mate with external threads148 formed on the screw 164. The proximal body portion 116 of the stemcomponent 112 may define a first pin stem opening 170 for receiving thefirst pin 166 as well as a second pin stem opening 172 for receiving thesecond pin 168. The pins 166 and 168 may be matingly fitted to theopenings 172 and 170. The proximal body portion 116 may further includea sleeve portion 126 which forms a pocket 132 for receiving the neckcomponent 118. The neck component 118 may include a screw opening 150for receiving the screw 164. The neck component 118 may further define afirst pin neck opening 174 for receiving a portion of the first pin 166as well as a second pin neck opening 176 for receiving the second pin168.

It should be appreciated that to minimize the number of loose parts thefirst pin 166 and the second pin 168 may be fixably secured to one ofthe neck component 118 or the stem component 112. It should beappreciated that the first pin 166 and the second pin 168 would then beslidably secured to the other of the stem component 112 and the neckcomponent 118.

The neck component 118 includes a distal body portion 122 as well as aproximal neck portion 120. The proximal neck portion 120 may define anexternal taper 162 which matingly receives a ball or head 160.

Referring now to FIG. 3A, yet another embodiment of the presentinvention is shown as hip stem 110A. The hip stem 110A is similar to thehip stem 110 of FIGS. 3 and 4, except that the neck component 118A isdifferent than the neck component 118 of the hip stem 110 of FIGS. 3 and4 in that the neck component 118A is modular or made of more than onecomponent. For example, as shown in FIG. 3A, the neck component 118Aincludes a distal body component 122A which is connectable to a proximalneck component 120A. It should be appreciated that the distal bodycomponent 122A and the proximal neck component 120A may be connected toeach other in any suitable fashion, for example they may be threadablyconnected, have a bayonet connection, have a press-fit connection or, asis shown in FIG. 3A, have a tapered connection. For example, the distalbody component 122A may include a tapered cavity 123A for receiving atapered protrusion 121A extending from the proximal neck component 120A.Hip stem 110A further includes a stem component 112A which together withthe neck assembly 118A forms the hip stem 110A.

Referring now to FIGS. 5, 6 and 7, yet another embodiment of the presentinvention is shown as Kit 200. The Kit 200 is for use in performing aprimary or a revision arthroplasty. The Kit 200 includes a first stemcomponent 212, a first neck component 218, and a second neck component318.

The first stem component 212 includes a distal stem portion 214 and aproximal body portion 216. The first stem component 212 may have anysuitable shape and may have a shape somewhat similar to the stemcomponent 12 of FIG. 1. As shown in FIG. 5, the first stem component 212may include a pocket 232 formed by sleeve 226 of the stem 212. Thepocket 232 is adapted for receiving the first neck component 218 or,alternatively, the second neck component 318.

As shown in FIG. 5, to secure the neck components 218 and 318 to thefirst stem component 212, the stem component 212 may include an aperture252 extending inwardly from planer face 236 of the pocket 232. Internalthreads 254 may be formed in aperture 252. The internal threads 254 maycooperate with external threads 256 formed on screw 244.

The first neck component 218 may be similar to the neck component 18 ofthe hip stem 10 of FIGS. 1 and 2. The first neck component 218, however,does not include a protrusion such as the protrusion 46 of the neckcomponent 18 of FIGS. 1 and 2. First neck component 218 includes adistal body portion 222 and a proximal neck portion 220 extending fromthe distal body portion 222.

The distal body portion 222 defines a planer face 240 for cooperationwith the planer face 236 of the first stem component 212. The distalbody portion 222 further defines a periphery 278 which mates with sleeve226 of the first stem component 212. The distal body portion 222 furtherdefines an opening 250 for receiving the screw 244. The proximal neckportion 220 defines a neck 264 from which extends an external taper 262.A head 260, as shown in phantom, may be fitted onto the external taper262.

The first neck component 218 defines a height H1, a neck length NL1 anda neck angle α NA1. The combination of neck height, length, and angleassist in positioning the head 260 with respect to the stem 212. Uniquepatient anatomies require that the head 260 be put in the properposition. By utilizing the kit 200 of the present invention, variousneck components can be utilized to provide for variations in theposition of the head.

For example, and as shown in FIG. 5, the kit 200 further includes asecond neck component 318. The second neck component 318 includesdifferent dimensions than the first neck component 218 so that the headmay be positioned in a different location than that obtained if thefirst neck component 218 is used.

For example, and as shown in FIG. 5, the second neck component 318includes a distal body portion 322 and a proximal neck portion 320.Distal body portion 322 includes a planer face 340 for cooperation withthe planer face 236 of the stem 212. The distal body portion 322 furtherdefines a periphery 378 for mating with sleeve 226 of the stem 214. Thedistal body portion 322 defines an opening 350 receiving the screw 244.

The proximal neck portion 320 defines a neck 364 which is connected tothe distal body portion 322. An external taper 362 extends from the neck364. As shown in FIG. 5, the periphery 366 of the distal body portion322 and the planer face 340, as well as the opening 350 of the secondneck component 318 have configurations compatible with the planer face340, the opening 350, and the periphery 266 of the distal body portion322 of the first neck component 218 in order that the first neckcomponent 218 and the second neck component 318 may be selectively usedwith the first stem component 212.

As shown in FIG. 5, the second neck component 318 may include a heightH2 which is different than the height H1 of the first neck component218. Similarly, the proximal neck portion 320 of the second neckcomponent 318 may define a neck length NL2 which is different than necklength NL1 of the proximal neck portion 220 of the first neck component218. Further, the proximal neck portion of the second neck component 318may define a neck angle α NA2 which is different than the neck angle αNA1 of the proximal neck portion 220 of the first neck component 218. Itshould be appreciated that different neck components may be accomplishedwhere only one of the neck height, neck length, and neck angle aredifferent from each other.

Referring again to FIG. 5 and according to the present invention a kit201 for use in performing revision surgery on the cavity 2 in the canal4 of the long bone 6 is shown. The cavity 2 extends from a resectedplane 11 of the long bone 6. The kit 20 includes first stem component orcanal component 212 having an external periphery 221. A portion of thecanal component 212 may be fitted to the cavity 2 in the canal 4 of thelong bone 6. The canal component 212 includes distal stem portion orcanal portion 214 having a first end 215 for insertion into the cavityand an opposed second end 217. The canal component 212 further includesa sleeve portion 226 extending from the second end 217 of the canalportion 212. The sleeve portion 226 has an internal periphery 219defining pocket or internal cavity 232. The sleeve portion 226 also hasan external periphery 227. The kit 201 also includes first neckcomponent or first joint component 218 removably connectable to thecanal component 212. The first joint component 218 has a proximal neckportion or body portion 220 and a distal body portion or connectionportion 222. The connection portion 222 of the first joint component 218has an external periphery 278. A portion of the external periphery 278of the connection portion 222 of the first joint component 218 may befitted into the internal cavity 232 of the sleeve portion 226 of thecanal component 212.

The kit 201 also includes a second neck component or a second jointcomponent 318 that is removably connectable to the canal component 212.The second joint component 318 has a proximal neck portion or bodyportion 320 and distal body portion or connection portion 322. Theconnection portion 322 of the second joint component 318 has an externalperiphery 378. A portion of the external periphery 378 of the connectionportion 322 of the second joint component 318 is fitted into theinternal cavity 232 of the sleeve portion 226 of the canal component 212so that the external periphery 378 of the connection portion 322 of thefirst joint component 218 is spaced inwardly from the external periphery227 of the sleeve portion 226 of the canal component 212 when the firstjoint component 218 is fixedly connected to the canal component 212 sothat the first joint component 218 may be removed from the long bone 6and replaced with the second joint component 318 without disturbing thefixation of the canal component 212 to the long bone 6.

The kit 201 may, as shown in FIG. 5, be configured such that the canalcomponent 212, the first joint component 218, and/or the second jointcomponent 318 define resection rings 231, 233 and 333, respectively, ona surface of the component. The resection rings 231, 233 and 333 may beused to align the component axially with the resection plane 11.

The first resection ring 231 as shown in FIG. 5 may be visuallydistinguishable from the exterior periphery or surface 227 of the canalcomponent 212 adjacent to the ring 231. It should be appreciated thatany or all of the resection rings 231, 233 and 333 may be invisible.

The kit 201, may as shown in FIG. 5, be configured such that a portionof the canal component 212 is extendable over a portion of at least oneof the first joint component 218 or the second joint component 318.

The kit 201 may, as shown in FIG. 5, be configured such that the firstjoint component 218 and the second joint component 318 have at least onedimension that is different from each other.

The kit 201 may, as shown in FIG. 5, be configured such that a portion236 of the external periphery 227 of the canal component 212 isgenerally planar. Further a portion 240 of the external periphery 278 ofthe connection portion 222 of the first joint component 218 may, asshown, be generally planar. The portion 236 of the external periphery227 of the canal component 212 and the portion 240 of the externalperiphery 278 of the connection portion 222 of the first joint component218 may, as shown, contact each other.

The kit 201 may, as shown in FIG. 5, also include a connector 244 toconnect the joint component 218 to the canal component 212. For example,the connector 244 may be in the form of a screw or as shown in FIG. 13as a pin.

The kit 201 may alternately (see FIG. 1) be constructed such that thefirst joint component 218 may include a protrusion. To cooperate withthe protrusion, the canal component 212 may define an aperture forreceiving the protrusion. The protrusion and the aperture may have anysuitable shape and may, for example, be cylindrical or tapered.

It should be appreciated that the canal component 212 may alternatelyinclude a protrusion (not shown). The first joint component 218 may theninclude an aperture for receiving the protrusion.

The kit 201 may (see FIG. 16) further include a prosthetic componentadapted for implantation to a second bone. The prosthetic component maycooperate with the first joint component 218. Further at least a portionof the body portion 220 of the first joint component 218 may include anarticulation surface for articulation with the prosthetic component.

The kit 201 may also include a prosthetic component for fixedimplantation to a second bone and for cooperation with the first jointcomponent. The kit 201 may also include a bearing component positionablebetween the first joint component and the prosthetic component. Thebearing component may articulate with the first joint component and/orthe prosthetic component.

As shown in FIG. 5, the first joint component 218 may be in the form of,for example, a hip neck. The canal component 212 may correspondingly bein the form of a hip stem. Further the kit may include hip head 260 forattachment to the hip neck 218 and an acetabular cup (see FIG. 16) forarticulating cooperation with the hip head 260.

Referring again to FIG. 5, the canal component 212 may define alongitudinal axis 235 and the internal periphery 219 and the externalperiphery 227 of the sleeve portion of the canal component may alsodefine a wall thickness WT2 therebetween. The wall thickness WT2 may, asshown, be generally uniform in a plane normal to the longitudinal axis235 of the canal component 212. The external periphery 278 of theconnection portion 222 of the first joint component 218 may be adaptedto closely conform to the internal periphery 219 of the sleeve portion226 of the canal component 212.

The canal component 212 may (see FIG. 18) be in the form of a humeralstem and the first joint component 218 may be in the form of a humeralneck. The kit 201 may also include a humeral head for connection withthe humeral neck.

Referring now to FIG. 5 the kit may also include connector 244 toconnect at the first joint component 218 or the second joint component318 to the canal component 212. The connector may be in the form of ascrew or a pin (See FIG. 16).

As shown in FIG. 6, the kit 200 may further include a second stemcomponent 312. The second stem component 312 may be different than thefirst stem component 212 and may include a distal stem portion 314 thatis longer, has a different angle, is narrower, or is larger or smallerin diameter than the distal stem portion 214 of the first stem component212.

As shown in FIG. 6, the second component 312 may define a pocket 332which has generally the same size and shape as the pocket 232 of thefirst stem component 212 such that either the first neck component 218or second neck component 318 may be compatible with the second stemcomponent 312 as well as with the first stem component 212. For example,the pocket 332 may be defined by the sleeve 326 extending from planersurface 336. The second stem component 312 may include a proximal bodyportion 316 that defines an aperture 352 defining internal threads 356which mate with external threads 256 of the screw 244.

Referring now to FIG. 7, the Kit 200 may further include a third neckcomponent 418. The third neck component 418 includes a distal bodyportion 422 and a proximal body portion 420. The distal body portion 422of the third neck component 418 may define planer surface 440 andperiphery 478. The surface 440 and periphery 478 which as shown in FIG.7 are selected such that the third neck component 418 may be compatibleand fit in the pocket 232 of the first stem 212.

The distal body portion 422 defines an opening 450 for receiving thescrew 244. The proximal neck portion 420 defines a neck 464 extendingfrom the distal body portion 422 and an external taper 462 that extendsfrom the neck 464 and that is adapted for cooperation with a ball orhead, for example head 460. It should be appreciated that the externaltaper 462, of third neck component 418 the external taper 362 of thesecond neck component 318, as well as the external taper 262 of thefirst neck component 218 may have similar sizes and shapes, such thatthe same head or similar heads may be accommodated by all of theassociated tapers of the associated neck components.

As shown in FIG. 7 the third neck component 418 defines a neck lengthNL3, a neck angle α NA3, and a neck height H3. It should be appreciatedthat at least one of the neck height H3, the neck length NL3 or the neckangle α NA3 may be different than the corresponding dimension for thefirst neck component 218 or the second neck component 318.

Referring now to FIG. 8, yet another embodiment of the present inventionis shown as hip stem 510. The hip stem 510 is different than the hipstem 110 of FIGS. 1 and 2 in that the hip stem 510 provides for twoassembly positions. For example, as shown in FIG. 8, hip stem 510 mayinclude an anterior assembly position 580 as is shown in solid and aposterior assembly position 582 as is shown in phantom.

It should be appreciated that as is shown in FIG. 8, the hip stem 510may be a right hip stem. It should be appreciated that for a left hipstem, the anterior assembly position and the posterior assembly positionwould be reversed.

According to the present invention, and as shown in FIG. 8, the hip stem510 includes a stem component 512 as well as a neck component 518. Thestem component 512 may be similar to the stem component 12 of FIGS. 1and 2, except that the stem component 512 includes a plurality ofmounting positions for mounting the neck component 518 onto the stemcomponent 512 in a plurality of positions. For example, as shown in FIG.8, the stem component 518 includes a first stem opening 570 forcooperating with first pin 566.

The stem component 512 further includes a second pin stem anterioropening 571 for receiving the second pin 568. When the second pin 568 ispositioned in the second pin stem anterior opening 571, the neckcomponent 518 is positioned with respect to the stem component 512 suchthat the hip stem 510 is in the posterior assembly position 582 as shownin phantom.

The stem component 512 further includes a second pin stem posterioropening 572. The second pin stem posterior opening 572 is adapted forlikewise receiving the second pin 568. When the second pin 568 ispositioned in the second pin stem posterior opening 572, the neckcomponent 518 is aligned with the stem component 512 such that the hipstem 510 is assembled into the anterior assembly position 580 is shownin solid.

Proximal body portion 516 of the stem component 512 includes a sleeveportion 526 for cooperation with bone and or cement.

The neck component 518 includes a distal body portion 522 defining aperiphery 578 thereof. The periphery 578 of the distal body portion 522is fitted within cavity or pocket 532 formed in the stem component 512by the sleeve portion 526. The distal body portion 522 of the neckcomponent 518 includes a first pin neck opening 574 as well as a secondpin neck opening 576. The first pin neck opening 574 cooperates with thefirst pin 566 while the second pin neck opening 576 cooperates with thesecond pin 568.

A neck 564 extends from the distal body portion 522 of the neckcomponent 518. An exterior taper 562 extends from the neck 564 andserves to receive head 560. The neck 564 and exterior taper 562 form theproximal neck portion 520 of the neck component 518. As can be seen bysimply rotating the component 518 after removing the second pin 568 fromthe stem component 512, the neck component 518 may be rotated aboutfirst pin 566 in the direction of arrows 584 to either anterior assemblyposition 580 or posterior assembly position 582.

Referring now to FIGS. 9 and 10, yet another embodiment of the presentinvention is shown as hip stem 610. The hip stem 610 of FIGS. 9, 10 and11 is different than the hip stem 10 of FIGS. 1 and 2 in that the hipstem 610 includes an external protrusion 646, which is different thanthe external protrusion 46 of the hip stem 10 in that the externalprotrusion 646 is rectangular rather than circular in cross-section. Forexample, and as shown in FIG. 9, the hip stem 610 includes a stemcomponent 612 as well as a neck component 618.

The stem component 612 includes a distal stem portion 614 forcooperation with the cavity 2 formed in the canal 4 of the femur 6. Thestem component further includes a proximal body portion 616 whichdefines a pocket 632 for receiving the neck component 618. An opening652 formed in the pocket 632 includes internal threads 656 forcooperation with external threads 648 formed on the screw 644. Theproximal body portion 616 of stem component 612 includes an aperture 648formed therein for receiving the external protrusions 646 extending fromneck component 618.

Referring now to FIG. 9-A, the external protrusion 646 and the aperture648 are shown in cross-section. The aperture 648 and the externalprotrusion 646 are defined by a protrusion width PW and a protrusionlength PL which defines a generally rectangular cross-section of theexternal protrusion 646, and correspondingly the aperture 648.

Referring again to FIG. 9, the external protrusion 646 further defines aprotrusion height PH extending along longitudinal axis 642 of the hipstem 610.

Referring to FIGS. 10 and 11, the neck component 618 includes a distalbody portion 622 and a proximal neck portion 620 extending from thedistal body portion 622. Stem component 612 includes a sleeve portion624 which defines a pocket 632 for receiving periphery 678 of the distalbody portion 622 of the neck component 618. The neck component 618includes the distal body portion 622 and the proximal neck portion 620.The proximal neck portion 620 includes a neck 664 and an external taper662 extending from the neck 664. A head 660 may mate with external taper662.

The external protrusion 646 may, as shown in FIGS. 10 and 11, be taperedand define first included angle αSQ1 and second included angle αSQ2

Referring now to FIG. 12, another embodiment of the present invention isshown as hip stem 710. The hip stem 710 is different than the hip stem10 of FIGS. 1 and 2 in that the hip stem 710 relies solely on aself-locking tapered connection to combine the components of the hipstem 710.

For example, and as shown in FIG. 12, the hip stem 710 includes a stemcomponent 712 as well as a neck component 718. The stem component 712includes a distal stem portion 714 and a proximal body portion 716. Theproximal body portion 716 defines a planer surface 736 from which acavity 748 extends.

The neck component 718 includes a distal body portion 722 and a proximalneck portion 720 extending from the distal body portion 722. The distalbody portion 722 includes a protrusion 746 extending from planer surface740 of the distal body portion 722.

The protrusion 746 is tapered and defines an included angle β of, forexample, two to twenty degrees (2°-20°) for a self locking taper, theangle β is defined by equation:tan β/2<μWhere:

-   -   μ=coefficient of friction    -   β=included angle

The protrusion 746 cooperates with the cavity 748 to lock the neckcomponent 718 to the stem component 712.

The distal body portion 722 fits within pockets 732 formed by the sleeveportion 726 of the proximal body portion 716 of the stem component 712.

The proximal neck portion 720 includes neck 764 from which externaltaper 762 extends. The head 760 is fitted onto external taper 762.

According to the present invention and referring now to FIG. 13, yetanother embodiment of the present invention is shown as prosthesis 800.The prosthesis 800 as shown in FIG. 13 is in the form of a hipprosthesis. The prosthesis 800 includes a hip stem 810. The hip stem 810is similar to the hip stem 110 of FIGS. 3 and 4. The hip stem 810includes a stem component 812 as well as a neck component 818.

The stem component 812 may be similar to the stem component 112 of FIGS.3 and 4. The stem component 812 includes a distal stem portion 814adapted to fit within cavity 2 of the canal 4 of femur 6. The stemcomponent further includes a proximal body portion 816 extending fromthe distal stem portion 814 of the stem component 812. The proximal bodyportion 816 includes an aperture 852 extending inwardly from inner face836 of the proximal body portion 816 of the stem component 812. Internalthreads 854 are formed in the aperture 852. The internal threads 854cooperate with external threads 848 formed on screw 851.

The neck component 818 is, as is shown in FIG. 13, connected to the stemcomponent 814 by any suitable connector, for example, by connector 844.The connector 844, as is shown in FIG. 13 includes the screw 851, aswell as, a first pin 866. The connector 844 may further include a secondpin 868 spaced from and parallel to the first pin 866.

The neck component 818 includes a distal body portion 822 and a proximalneck portion 820 extending from the distal body portion 822. The distalbody portion 822 includes an aperture 850 for receiving the screw 851.The distal body portion 822 further includes a first pin neck opening874 for cooperating with the first pin 866 and a second pin neck opening876 for cooperating with the second pin 868. The distal body portion 822further defines a planar face 840 for cooperation with a planar face 836of the stem component 812.

The proximal body portion 816 of the stem component 812 includes a firstpin stem opening 870 for cooperation with the first pin 866 and a secondpin stem opening 872 for cooperation with the second pin 868. Theproximal body portion 816 of the stem component 812 includes a sleeveportion 826 defining a pocket 832 for receiving periphery 878 of thedistal body portion 822 of the neck component 818.

The proximal neck portion 820 of the neck component 818 includes a neck864 as well as external taper 862 extending from the neck 864.

In addition to the hip stem 810, the prosthesis 800 further includes ahead 860 which matingly fits on external taper 862 of the neck component818. The prosthesis 800 further includes an acetabular cup 886 forcooperation with acetabulum 9 of the patient. The acetabular cup 886 mayinclude a feature in the form of, for example, a porous coated surface888 for promoting boney in-growth between the acetabulum 9 and theacetabular cup 886. The prosthesis 800 may include a bearing 890positioned between the acetabular cup 886 and the head 860. It should beappreciated that the acetabular cup 886 may directly cooperate with thehead 860.

It should be appreciated that the hip stem 810, head 860, acetabular cup886, and bearing 890 may be made of any suitable durable material. Thehip stem 810 including the distal stem portion 814, the neck component818, as well as pins 866 and 868 and the screw 864, may all be made of asuitable durable material. The materials for the components of theprosthesis 800 may, for example, be made of a plastic, a metal, or acomposite. The material for which the prosthesis is made preferably iscompatible with the human anatomy. The prosthesis 800, if made of ametal may for example be made of a cobalt chromium alloy, a stainlesssteel alloy, or a titanium alloy.

The bearing 890 of the prosthesis 800 may for example, be made of ametal, a ceramic, or a plastic. The head 860 may be made of a metal, ora ceramic.

According to the present invention and referring now to FIGS. 14-16, yetanother embodiment of the present invention is shown as prosthesis 800A.The prosthesis 800A is shown in FIG. 14 in the form of a hip prosthesis.The prosthesis 800A includes a hip stem 810A. The hip stem 810A issimilar to the hip stem 810 of FIG. 13 except the hip stem 810A providesfor posterior version for hip stems for both the right leg and the leftleg of the patient. The hip stem 810A includes a stem component 812A aswell as a right neck component 818A as shown in FIG. 14 and a left neckcomponent 819A as shown in FIG. 15.

As shown in FIG. 16, the stem component 812A may be similar to the stemcomponent 812 of FIG. 13. The stem component 812A includes a distal stemportion 814A adapted to fit within cavity 2 of the canal 4 of femur 6.The stem component 812A further includes a proximal body portion 816Aextending from the distal stem portion 814A of the stem component 812A.The proximal body portion 816A includes an aperture 852A extendinginwardly from inner face 836A of the proximal body portion 816A of thestem component 812A. Internal threads 854A are formed in the aperture852A. The internal threads 854A cooperate with external threads 848Aformed on screw 851A.

The right neck component 818A and the left neck component 819A are thusalternatively connected to the stem component 182A. The components 818Aand 819A may be connected to the stem component 812A by any suitableconnector.

The right neck component 818A is shown connected to the stem component812A in FIG. 16. It should be appreciated that the left neck component819A is likewise, similarly connected to the stem component 812A.

The right neck component 818A is, as is shown in FIG. 16, connected tothe stem component 814A by, for example, connector 844A. The connector844A, as is shown in FIG. 16 includes the screw 851A, as well as, afirst pin 866A. The connector 844A may further include a second pin 868Aspaced from and parallel to the first pin 866A.

The right neck component 818A includes a distal body portion 822A and aproximal neck portion 820A extending from the distal body portion 822A.The distal body portion 822A includes an aperture 850A for receiving thescrew 851A. The distal body portion 822A further includes a first pinneck opening 874A for cooperating with the first pin 866A and a secondpin neck opening 876A for cooperating with the second pin 868A. Thedistal body portion 822A further defines a planar face 840A forcooperation with an inner face 836A of the stem component 812A.

The proximal body portion 816A of the stem component 812A includes afirst pin stem opening 870A for cooperation with the first pin 866A anda second pin stem opening 872A for cooperation with the second pin 868A.The proximal body portion 816A of the stem component 812A includes asleeve portion 826A defining a pocket 832A for receiving periphery 878Aof the distal body portion 822A of the right neck component 818A.

As shown in FIG. 14, the proximal neck portion 820A of the right neckcomponent 818A includes a right neck 864A as well as a right externaltaper 862A extending from the right neck 864A. The right neck 864Aextends posteriorly from the distal body portion 822A of the right neckcomponent 818A at an angle θθ of, for example, 10 to 40 degrees. Theposterior extension is intended to mimic the geometry of the naturalright femur.

As shown in FIG. 15, the proximal neck portion 821A of the left neckcomponent 819A includes a left neck 865A as well as a left externaltaper 863A extending from the left neck 865A. The left neck 865A extendsposteriorly from the distal body portion 823A of the left neck component819A at an angle θθθ of, for example, 10 to 40 degrees. While as shownin FIG. 15 the neck 865A extends downwardly, it should be appreciatedthat shape when placed in a left femur will extend posteriorly. Theposterior extension is intended to mimic the geometry of the naturalleft femur.

It should be appreciated that both the right neck component 818A of FIG.14 and the left neck component 819A of FIG. 15 may be used with theidentical stem component 812A. This may be accomplished by providing theleft external taper 863A of the left neck component 819A with identicaldimensions to that of the right external taper 862A of the right neckcomponent 818A. Thus both the right external taper 862A and the leftexternal taper 863A may mate with the internal taper of the stemcomponent 812A.

Referring again to FIG. 16, in addition to hip stem 810A, the prosthesis800 further includes a head 860A, which matingly fits on external taper862A or 863A of either of the neck components 818A and 819Arespectively. The prosthesis 800A further includes an acetabular cup886A for cooperation with acetabulum 9 of the patient. The acetabularcup 886A may include a feature in the form of, for example, a porouscoated surface 888 for promoting boney in-growth between the acetabulum9 and the acetabular cup 886A. The prosthesis 800A may include a bearing890A positioned between the acetabular cup 886A and the head 860A. Itshould be appreciated that the acetabular cup 886A may directlycooperate with the head 860A.

It should be appreciated that the hip stem 810A, head 860A, acetabularcup 886A, and bearing 890A may be made of any suitable durable material.The hip stem 810A including the distal stem portion 814A, the neckcomponents 818A and 819A, as well as the pins 866A and 868A and thescrew 864A, may all be made of a suitable durable material. Thematerials for the components of the prosthesis 800A may, for example, bemade of a plastic, a metal, or a composite. The material for which theprosthesis is made preferably is compatible with the human anatomy. Theprosthesis 800A, if made of a metal may, for example, be made of acobalt chromium alloy, a stainless steel alloy, or a titanium alloy.

The bearing 890A of the prosthesis 800A may for example, be made of ametal, a ceramic, or a plastic. The head 860A may be made of a metal, ora ceramic.

According to the present invention and referring to FIG. 17 anotherembodiment of the present invention is shown as prosthesis 900. Theprosthesis 900 as shown in FIG. 17 is for use in the knee joint. Theorthopedic prosthesis 900 as shown in FIG. 16 includes a tibialcomponent 910, a bearing 990 and a femoral component 992.

The tibial component 910 for the prosthesis 900 is for use with tibia 5.The tibial component 910 includes a joint component 918 and a stemcomponent 912. The stem component 912 fits within the intramedullarycanal 7 of the tibia 5. The stem component 912 includes a distal stemportion 914 as well as a proximal body portion 916. Proximal bodyportion 916 of the stem component 912 defines a pocket 932 formed fromsleeve portion 926 of the proximal body portion 916. A connector 944 isused to connect the stem component 912 to the joint component 918.

The joint component 918 includes an articulation portion 920 and adistal body portion 922 extending from the articulation portion 920. Thedistal body portion 922 of the joint component 918 defines a protrusion946 which cooperates with the pocket 932 formed by the sleeve 926 of thestem component 912.

The connector 944 connects the joint component 918 to the stem component912. The connector 944 may have any suitable shape and may, as shown inFIG. 17, include a screw 964 as well as a first pin 966 and a second pin968. The pins 966 and 968 engage with the joint component 918 and withthe stem component 912. The screw 964 includes external threads 948which cooperate with internal threads 954 formed on the proximal bodyportion 916 of the stem component 912. As shown in FIG. 17, thearticulation portion 920 of the joint component 918 extends transverselyor perpendicular to longitudinal axis 942 of the stem component 912substantially past the stem component 912.

The sleeve 926 may extend, as shown in FIG. 17, up against the taper ofthe pocket 932. The sleeve 926 may, as shown in FIG. 17, extend outtransversely from the longitudinal axis 942 and define a planer surface936 of the stem component 912. Similarly, the joint component 918 mayinclude a planer portion 940 extending transversely from thelongitudinal axis 942. The planer portions 936 and 940 may cooperatewith each other to support and form the stem component 912.

As shown in FIG. 17, the orthopedic prosthesis 900 further includes afemoral component 992 connected to cavity 2 formed in canal 4 of thefemur 6. The femoral component 992 cooperates with the joint component918 of the stem 912. The femoral component 992 may cooperate directlywith the tibial component 910. The orthopedic prosthesis 900 may furtherinclude a bearing 990 supported by the articulating portion 920 of thejoint component 918. The bearing 990 may, for example, be made of apliable material, for example, a plastic.

The femoral component 992 and the stem component 912 may be made of anysuitable material, for example, a plastic, a composite, or a metal andif made of a metal, for example, cobalt chromium alloy, stainless steelalloy, or titanium alloy.

Referring now to FIG. 18, yet another embodiment of the presentinvention is shown as shoulder prosthesis 1000. The shoulder prosthesis1000 includes a stem 1010 and a glenoid 1094. The stem 1010 includes astem component 1012 for cooperation with humerus 9.

The stem component 1012 includes a distal stem portion 1014 and aproximal body portion 1016. The proximal body portion 1016 includes asleeve 1026 defining a pocket 1032 therein. Within the pocket 1032 astem planer face 1036 is formed. Extending distally from the stem planerface 1036 is a tapered aperture 1048. Extending distally from thetapered aperture 1048 is a cylindrical aperture 1052 having internalthreads 1056 formed thereon.

The stem 1010 further includes a neck component 1018 having a distalbody portion 1022 and a proximal neck portion 1020. The distal bodyportion 1022 defines an aperture 1050 therein.

The distal body portion 1022 defines a distal body planer face 1040 aswell as a periphery 1078. The periphery 1078 and the neck planer face1040 cooperate with pocket 1032 to position the neck component 1018 withthe stem component 1012. The neck component 1018 further includes aprotrusion 1046 extending from the planer face 1040. The protrusion 1046matingly fits with the aperture 1048 to provide a taper-lock of the neckcomponent 1018 to the stem component 1012.

While the neck component 1018 may be securely fastened to the stemcomponent 1012 by means of the protrusion in taper lock, it should beappreciated that the shoulder prosthesis 1000 may further include aconnector in the form of a screw 1044. The screw 1044 fits within theaperture 1050 of the neck component 1018 and includes external threads1049 that cooperate with the internal threads 1056 formed on the stemcomponent 1012.

The proximal neck portion 1020 includes an external taper 1062. Theexternal taper 1062 is adapted to receive head 1060. The head 1060cooperates with glenoid 1094 secured to glenoid facia 3 by pigs 1086.Stem 1010, head 1060, and glenoid 1094 may be made of any suitabledurable material. The stem 1010 including the stem component 1012 andthe neck component 1018 as well as the screw 1044 may be made, forexample, of a plastic, a metal, or a composite. If made of a metal, theneck component 1018, stem component 1012, and screw 1044 may be made of,for example, a cobalt chromium alloy, a stainless steel alloy, or atitanium alloy. The glenoid 1094 may be made of a metal or be made of,for example, a more pliable material, for example, a plastic.

Referring now to FIG. 19, yet another embodiment of the presentinvention is shown as kit 1100. The kit 1100 includes the trial hip stem1110 and the implant hip stem 1210. The trial hip stem 1110 and theimplant hip stem 1210 preferably have similar, if not almost identical,shapes and dimensions. The trial 1110 is implanted into the body andused to perform a trial reduction or to verify the dimensions andselection of the hip stem components. The trial is removed after a trialreduction and the corresponding implant is permanently secured into thebone of the patient. The use of the trial verifies the selection of theimplant and if the trial selection is believed to be sub-optimum, analternate trial is used in the patient and if that alternate trial isfound to be optimum, its corresponding implant is then implanted intothe patient.

Trial 1110 includes a trial stem component 1112 and a trial neckcomponent 1118. The trial stem component 1112 includes a distal stemportion 1114 and a proximal body portion 1116. The proximal body portion1116 includes a sleeve portion 1126 defining a pocket 1132 and a surface1136. Extending distally from the surface 1136 is a cavity 1148.

The trial 1110 further includes the trial neck component 1118. The trialneck component 1118 includes a distal body portion 1122 and a proximalneck portion 1120. The distal body portion 1122 includes a periphery1178 for fitting against a sleeve portion 1126 of the stem component1112. The distal body portion 1122 further includes a surface 1140 formating with the surface 1136 of the stem component 1112. The distal bodyportion 1122 also includes a protrusion 1146 which mates with cavity1148 of the stem component 1112. The protrusion 1146 defines includedangle ββ.

The angle ββ is selected to provide for a self-locking taper betweenprotrusion 1146 and the cavity 1148. The angle ββ may be, for example,from two to twenty degrees (2°-20°).

The angle ββ is preferably selected by the formula:Tan ββ/2<μwhere:

-   -   μ=coefficient of friction    -   ββ=included angle

The proximal neck portion 1120 includes an external taper 1162 to whichhead 1160 is matingly fitted.

The implant hip stem 1210 has a size and shape the same as trial 1110.For example, the implant 1210 includes a stem component 1212 having adistal stem 1212 portion 1214 and a proximal body portion 1216. Theproximal body portion 1216 includes a sleeve portion 1226 definingpocket 1232. The pocket 1232 includes a surface 1236 as well as a cavity1248 extending below the surface 1236.

The implant hip stem 1210 also includes a neck component 1218 includinga distal body portion 1222 and a proximal neck portion 1220. The distalbody portion 1222 defines a periphery 1278 thereof, as well as a surface1240 of the distal body portion 1222. A protrusion 1246 extendsdownwardly from the surface 1240 and defines an included angle ββ. Theproximal neck portion 1220 includes an external taper 1262 to which head1260 is matingly fitted.

The trial stem component 1112 may be first implanted into the patientand the trial neck component 1118 may be secured to the trial stemcomponent 1112. Alternatively, the implant stem component 1212 may bepermanently secured to the patient and the trial neck component 1118 maybe fitted to the implant stem component 1212.

The trial neck component 1118 may be secured to the implant stemcomponent 1212 and a trial reduction made. If the trial reduction issatisfactory, the implant neck component 1218, which is identical to thetrial neck component 1118, may be implanted into the patient. If,however, the trial neck component 1118 is found in a trial reduction tonot be optimum, an alternate trial neck component may be utilized in atrial reduction attempted with the new trial neck component. If thatsecond trial neck component is found to be satisfactory, a correspondingimplant neck component is then implanted.

According to the present invention and referring again to FIG. 19, a kit1101 for use in performing joint arthroplasty is shown. The kit 1101includes the orthopaedic stem trial or trial hip stem 1110 for use inperforming joint arthroplasty. The trial 1110 may be fitted to a cavity2 in the canal 4 of a long bone 6 and assists in performing a trialreduction in performing joint arthroplasty. The orthopaedic stem trial1110 includes canal component or trial stem component 1112 having anexternal periphery 1113. A portion of the canal component 1112 may befitted to the cavity 2 in the canal 4 of the long bone 6. The canalcomponent 1112 includes distal stem portion or canal portion 1114 thathas a first end 1115 for insertion into the cavity 2 and an opposedsecond end 1117. The canal component 1112 further includes a sleeveportion 1126 extending from the second end 1117 of the canal portion1114. The sleeve portion 1126 has an internal periphery 1119 thatdefines pocket or internal cavity 1132. The sleeve portion 1126 also hasan external periphery 1121.

The orthopaedic stem trial 1112 also includes trial neck component orjoint component 1118 removably connectable to the canal component 1112.The joint component 1118 has neck portion or body portion 1120 anddistal body portion or connection portion 1122. The connection portion1122 of the joint component 1118 defines an external periphery 1178. Aportion of the external periphery 1121 of the sleeve portion 1126 may befitted to the cavity 2 of the long bone 6. At least a portion of theexternal periphery 1178 of the connection portion 1122 of the jointcomponent 1118 may be fitted into the internal cavity 1132 of the sleeveportion 1126 so that the external periphery 1178 of the connectionportion 1122 of the joint component 1118 is spaced inwardly from theexternal periphery 1121 of the sleeve portion 1126 of the stem component1112 when the joint component 1118 is fixedly connected to the stemcomponent 1112 so that the joint component 1118 may be removed from thelong bone 6.

The kit 1101 includes orthopaedic hip stem or orthopaedic stem implant1210 for use in performing joint arthroplasty. The implant 1210 may befitted to cavity 2 in canal 4 of long bone 6 to perform a jointarthroplasty. The orthopaedic stem implant 1210 includes implant stemcomponent or canal component 1212 having an external periphery 1221. Atleast a portion of the canal component 1212 may be fitted to the cavity2 in the canal 4 of the long bone 6. The canal component 1212 includesdistal stem portion or canal portion 1214 having a first end 1215 forinsertion into the cavity 2 and an opposed second end 1217. The canalcomponent 1212 further includes sleeve portion 1226 extending from thesecond end 1217 of the canal portion 1214. The sleeve portion 1226 hasan internal periphery 1219 that defines pocket or internal cavity 1232.The sleeve portion 1226 also has an external periphery 1221. Theorthopaedic stem implant 1210 also includes implant neck component orjoint component 1218 that may be removably connected to the canalcomponent 1212. The joint component 1218 has distal body portion orconnection portion 1222 and neck portion or body portion 1220. Theconnection portion 1222 of the joint component 1218 defines externalperiphery 1278. A portion of external periphery 1221 of the sleeveportion 1226 may be fitted to the cavity 2 of the long bone 6. A portionof the external periphery 1278 of the connection portion 1222 of thejoint component 1218 may be fitted into the internal cavity 1232 of thesleeve portion 1226. The external periphery 1278 of the connectionportion 1222 of the joint component 1218 is spaced thereby inwardly fromthe external periphery 1221 of the sleeve portion 1226 of the stemcomponent 1212. This is accomplished when the joint component 1218 isfixedly connected to the stem component 121. The joint component 1218may thereby be removed from the long bone without disturbing thefixation of the stem component 1212 to the long bone 6.

Referring now to FIG. 20, yet another embodiment of the presentinvention is shown as method 1300 for treating orthopedic joint diseaseof the patient. The method 1300 includes a first step 1310 of implantingan orthopedic implant into a cavity in the canal of the long bone. Theorthopedic implant includes a stem component and a first joint componentfixedly connectable to the joint component. The joint component isadapted for removal from the long bone without disturbing the fixationof the stem component to the bone. The method 1300 includes a secondstep 1312 of monitoring the condition of the patient and a third step1314 of determining that the patient needs a revision prosthesis. Themethod 1300 also includes a fourth step 1316 of providing a second jointcomponent compatible with the stem component. The method 1300 furtherincludes a fifth step 1318 of removing the first joint component fromthe stem component of the orthopedic implant in vivo without disturbingthe fixation of the stem component to the bone the orthopedic implant.The method 1300 further includes a sixth step 1320 of implanting thesecond joint component into the stem component in vivo in the patient.

According to the present invention and referring now to FIG. 21, yetanother embodiment of the present invention is shown as surgical method1400. The method 1400 represents a method for providing revision jointarthroplasty on a patient having an orthopedic implant. The orthopedicimplant includes a stem component and a first joint component fixedlyconnectable to the stem component. The joint component is adapted forremoval from the long bone without disturbing the fixation of the stemcomponent to the bone. The method 1400 includes a first step 1410 ofmonitoring the condition of the patient and a second step 1412 ofdetermining whether the patient needs a revision prosthesis. The method1400 includes a third step 1414 of providing a second joint componentcompatible with the stem component. The method 1400 further includes afourth step 1416 of removing the first joint component from the stemcomponent of the orthopedic implant in vivo in the patient withoutdisturbing the fixation of the stem component to the bone. The method1400 further includes a fifth step 1418 of implanting the second jointcomponent in vivo in the patient.

Referring now to FIG. 22, another aspect of the present invention isshown as method 1500 for treating orthopaedic joint disease of apatient. The method 1500 includes a first step 1510 of resecting a longbone along a resection plane and a second step 1512 preparing a cavityin the canal of the long bone. The method also includes a third step1514 of implanting an orthopaedic implant into a cavity in the canal ofthe long bone. The orthopaedic implant includes a joint component havinga canal element and a first body element. The first body element may befixedly connected to the canal element. The orthopaedic implant issecured in the canal of the long bone with the first body element beingspaced from the long bone. The method further includes a fourth step1516 of monitoring the condition of the patient and a fifth step 1518 ofdetermining that the patient needs a revision prosthesis. The methodalso includes a sixth step 1520 of providing a second body elementconnectable to the canal element and a seventh step 1522 of removing thefirst body element from the canal element of the orthopaedic implant invivo in the patient without disturbing the fixation of bone surroundingthe canal element of the orthopaedic implant and without damaging bonesurrounding the first body element. The method further includes aneighth step 1524 of implanting the second body element into the canalelement in vivo in the patient.

Referring now to FIG. 23 a method 1600 for providing joint arthroplastyon a joint of a patient with an orthopaedic implant is shown. The method1600 includes a first step 1610 of resecting a long bone along aresection plane and a second step 1612 of preparing a cavity in thecanal of the long bone. The method also includes a third step 1614 ofimplanting an orthopaedic implant canal component into a cavity in thecanal of a long bone. The orthopaedic implant canal component may have astem element and a first body element fixedly connectable to the stemelement. The orthopaedic implant canal component is secured in the canalof the long bone. The method further includes a fourth step 1616 ofconnecting an orthopaedic trial body component to the implant canalcomponent, the orthopaedic trial body component being spaced from thelong bone and a fifth step 1618 of performing a trial reduction of thejoint of the patient. The method also includes a sixth step 1620 ofdetermining if the orthopaedic trial body component providessatisfactory results for the patient and a seventh step 1622 ofimplanting an orthopaedic implant body component corresponding to theorthopaedic trial body component onto the orthopaedic implant canalcomponent if the orthopaedic trial body component provides satisfactoryresults for the patient.

The third step 1614 of implanting the canal component step may furtherinclude permanently securing the canal component to the long bone.

The third step 1614 of implanting the canal component step may furtherinclude positioning the canal component such that the canal componentintersects the resection plane.

Referring now to FIG. 24 the present invention may be in the form of akit 1700 for use in performing joint arthroplasty. The kit 1700 includesa canal component implant 1712I having an external periphery 1713I. Aportion of the canal component implant 1712I may be fitted to a cavity 2in a canal 4 of a long bone 6. The canal component implant 1712Iincludes a canal portion 1714I. The canal portion 1714I has a first end1715I for insertion into the cavity 2 and an opposed second end 1717I.

The canal component implant 1712I further including a sleeve portion1726I extending from the second end 1717I of the canal portion 1714I.The sleeve portion 1726I has an internal periphery 1719I defining aninternal cavity 1732I. The sleeve portion 1726I also has an externalperiphery 1721I. The kit 1700 also includes a first joint componentimplant removeably connectable to the canal component implant. The firstjoint component implant 1718I has a body portion 1720I and a connectionportion 1722I. The connection portion 1722I of the first joint componentimplant 1718I has an external periphery 1778I. A portion of the externalperiphery 1778I of the connection portion 1722I of the first jointcomponent implant 1718I may be fitted into the internal cavity 1732I ofthe sleeve portion 1726I of the canal component implant 1712I, so thatthe external periphery 1778I of the connection portion 1722I of thefirst joint component implant 1718I is spaced inwardly from the externalperiphery 1721I of the sleeve portion 1726I of the canal componentimplant 1712I when the first joint component implant 1718I is fixedlyconnected to the canal component implant 1712I so that the first jointcomponent implant 1718I may be removed from the long bone 6 withoutdisturbing the fixation of the canal component implant 1712I to the longbone 6.

The kit 1700 also includes a first joint component trial 1718T generallycorresponding in size and shape with the first joint component implant1718I. The first joint component trial 1718T may be removeably connectedto the canal component implant 1712I. The first joint component trial1718T having a body portion 1720T and a connection portion 1722T. Theconnection portion 1722T of the first joint component trial 1718T has anexternal periphery 1778T. A portion of the external periphery 1778T ofthe connection portion 1722T of the first joint component trial 1718Tmay be fitted into the internal cavity 1732I of the sleeve portion 1726Iof the canal component implant 1712I. The external periphery 1778T ofthe connection portion 1722T of the first joint component trial 1718T isthereby spaced inwardly from the external periphery 1721T of the sleeveportion 1726T of the canal component implant 1712I. This occurs when thefirst joint component trial 1718T is fixedly connected to the canalcomponent implant 1712I. The first joint component trial 1718T may thusbe removed from the long bone 6 without disturbing the fixation of thecanal component implant 1712I to the long bone 6.

The kit further includes a second joint component implant 1818Iremoveably connectable to the canal component implant 1712I. The secondjoint component implant 1818I has a body portion 1820I and a connectionportion 1822I. The connection portion 1822I of the second jointcomponent implant 1818I has an external periphery 1878I. A portion ofthe external periphery 1878I of the connection portion 1822I of thesecond joint component implant 1818I may be fitted into the internalcavity 1732I of the sleeve portion 1726I of the canal component implant1712I so that the external periphery 1878I of the connection portion1822I of the second joint component implant 1818I is spaced inwardlyfrom the external periphery 1721I of the sleeve portion 1726I of thecanal component implant 1712I when the second joint component implant1818I is fixedly connected to the canal component implant 1712I so thatthe second joint component implant 1818I may be removed from the longbone 6 without disturbing the fixation of the canal component implant1712I to the long bone 6.

The kit 1700 also includes a second joint component trial 1818Tgenerally corresponding in size and shape with the second jointcomponent implant 1818I. The second joint component trial 1818T may beremoveably connectable to the canal component implant 1712I. The secondjoint component trial 1818T having a body portion 1820T and a connectionportion 1822T. The connection portion 1822T of the second jointcomponent trial 1818T has an external periphery 1878T. A portion of theexternal periphery 1878T of the connection portion 1822T of the secondjoint component trial 1818T may be fitted into the internal cavity 1732Iof the sleeve portion 1726I of the canal component implant 1712I so thatthe external periphery 1878T of the connection portion 1822T of thesecond joint component trial 1818T is spaced inwardly from the externalperiphery 1721I of the sleeve portion 1726I of the canal componentimplant 1712I when the second joint component trial 1818T is fixedlyconnected to the canal component implant 1712I so that the second jointcomponent trial 1818T may be removed from the long bone 6 withoutdisturbing the fixation of the canal component implant 1712I to the longbone 6.

The kit 1700 permits the canal component implant 1712I to be permanentlyimplanted. The kit 1700 also permits the first joint component trial1718T to be assembled to the canal component implant 1712I and used toperform a trial reduction. The kit 1700 further permits the first jointcomponent trial 1718T to be replaced with the second joint componenttrial 1818T if the trial reduction has unsatisfactory results.

Referring now to FIG. 25, an orthopaedic implant 2011 is used to performjoint arthroplasty. A portion of the orthopaedic implant 2011 is capableof being fitted to cavity 2 in the canal 4 of long bone 6. The cavity 2extends from a resected plane 11 of the long bone 6. The orthopaedicimplant 2011 includes joint component 2010. The joint component 2010includes stem element 2012 defining external periphery 2058 of the stemelement 2012. The stem element 2012 has a first end 2015 for insertioninto the cavity 2. The external periphery 2058 of the stem element 2012has a stem resection ring 2041. The stem resection ring 2041 may bealigned with the resected plane 11 of the long bone 6.

The joint component 2010 also includes a first body element 2018 capableof being fixedly fitted to the stem element 2012. The first body element2018 includes an external periphery 2078. The external periphery 2078 ofthe first body element 2018 has a body component ring 2043. The bodycomponent ring 2043 may be aligned with the resected plane 11 of thelong bone 6. A canal portion 2045 of the first body element 2018 extendsgenerally from the component ring 2043 of the external periphery 2078 ofthe first body element 2018 toward the first end 2015 of the stemelement 2012 when the first body element 2018 is fixedly connected tothe stem element 2012.

The external periphery 2047 of the canal portion 2045 of the first bodyelement 2018 is spaced inwardly from external periphery 2058 of the stemelement 2012 when the first body element 2018 is fixedly connected tothe stem element 2012 so that the first body element 2018 may be removedfrom the long bone 6 without disturbing the fixation of the stem element2012 to the long bone 6.

As shown in FIG. 25 the orthopaedic implant 2011 may be configured suchthat the first mentioned body element 2018 may be removably fixedlyconnected to the stem element 2012 and may include a second body element2018S that may be removably fixedly connected to the stem element 2012.The first body element 2018 and the second body element 2018S may thusbe interchangeably connected to the stem element 2012 while the stemelement 2012 is implanted in the cavity 2 of the long bone 6.

The orthopaedic implant 2011 may have a portion of the stem element 2012that extends over a portion of the first body element 2018.

The stem element 2012 of the orthopaedic implant, as shown in FIG. 25,may include a sleeve portion 2016. The sleeve portion 2016 may receiveat least a portion of the canal portion 2045 of the first body element2018.

The first body element 2018 of the orthopaedic implant 2011, as shown inFIG. 25, may be removably securable to the stem element 2012.

As shown in FIG. 25, a portion 2036 of the external periphery 2058 ofthe stem element 2012 may be generally planar. Also a portion 2040 ofthe external periphery of the body element 2018 may be generally planar.The portion 2036 of the external periphery 2058 of the stem element 2012and the portion 2040 of the external periphery 2078 of the body element2018 may be in contact with each other.

A connector 2044 may be used to connect the body element 2018 to thestem element 2012. The connector 2044 may be in the form of a screw or apin (see FIG. 16).

The body element 2018 may include a protrusion 2044 extending from asurface of the connection element 2022. The stem element 2012 mayinclude an aperture 2048 for receiving the protrusion 2046. It should beappreciated that the body may include an aperture (not shown) and thestem element may include a protrusion (not shown). The protrusion may betapered.

The implant 2011 may further include second joint component 2010S forcooperation with a first joint component 2010. A portion of the externalperiphery of the body element 2018 may include an articulation surface2017 for articulation with the second joint component 2010S.

The second joint component 2010S may be adapted for fixed implantationonto a second bone 17. A bearing component 2055 may be positionedbetween the first joint component 2010 and the second joint component2010S. The bearing component 2055 articulates at the first jointcomponent 2010 and is fixedly attached to the second joint component2010S. Alternately the bearing component 2055 may articulate with thesecond joint component 2010S and be fixedly attached to the first jointcomponent 2010.

As shown in FIG. 25, the orthopaedic implant 2011 may be in the form ofa hip implant. The joint component 2010 is in the form of a hip stem.The orthopaedic implant 2011 may also include the second joint component2010S in the form of an acetabular cup for articulating cooperation withthe hip stem.

As shown in FIG. 25, the body element 2018 may include a taperedprotrusion 2059. The orthopaedic implant 2011 may also include agenerally spherical head 2060. The head 2060 may, as shown, be removablyfixedly secured to the tapered protrusion 2059.

As shown in FIG. 1, the joint component defines a longitudinal axis2039. The stem element 2012 may have a sleeve portion 2026. The sleeveportion 2026 may define a wall thickness WT3 of the sleeve portion 2026.The wall thickness WT3 may generally be uniform about the outerperiphery 2058 of the stem element 2012 in a plane normal to thelongitudinal axis 2039 of the joint component 2010 and may be defined bywall thickness WT3. The external periphery 2078 of the body element 2018may, as shown, closely conform to the sleeve portion 2026 of the stemelement 2012.

It should be appreciated that the orthopaedic implant 2011 may be in theform of a knee prosthesis, a hip prosthesis or a shoulder prosthesis.

Referring again to FIG. 25, it should be appreciated that the stemelement 2012 may be interchangeably connectable to the first jointelement 2018 and with the second joint element 2018S. The first jointelement 2018 and the second joint element 2018S may as shown include adifferent dimension, or several different dimensions from each other.Thus, it should be appreciated that the stem element can receive jointelements of varying heights, offsets and degrees of version.

Continuing to refer to FIG. 25, the stem resection ring 2041 may be inthe form of a recess. The recess 2041 may be a score mark or a machinedor formed groove. It should be appreciated that the ring may likewise bea raised area or protrusion (not shown). It should be furtherappreciated that the ring 2041 may be acid etched or marked with ink orpaint. It should be appreciated that the ring 2041 may be continuous ordiscontinuous around the stem 2012.

It should be appreciated that body element 2018 may likewise includebody component ring 2043. The body component ring 2043 may have the sameconfiguration as that of the stem resection ring 2041 and may berecessed or protruding.

It should be appreciated that the stem resection ring 2041 and/or thebody component ring 2043 may, as shown in FIG. 25, be visuallydistinguishable from the external periphery 2058 of the stem element2012 and/or the external periphery 2078 of the body element 2018.

It should likewise be appreciated that the stem resection ring 2041and/or the body component ring 2043 may be visually indistinguishablefrom the external periphery 2058 of the stem element 2012 and/or theexternal periphery 2078 of the body element 2018. The stem resectionring 2041 and/or the body component ring 2043 may thus be invisible.

According to the present invention and referring to FIG. 26, a firstjoint component 2118 for use with a stem component 2112 having a canalportion 2114 and a sleeve portion 2116 for use as part of a prothesis2101 in performing joint arthroplasty is shown. The sleeve portion 2116of the stem component 2112 has an internal periphery 2134 and anexternal periphery 2158. A portion of the external periphery 2158 of thesleeve portion 2116 of the stem component 2112 may be fitted to a cavity2 in the canal 4 of a long bone 6. The cavity 2 extends from a resectedplane 11 of the long bone 6.

The first joint component 2118 includes a body portion 2122 and aconnection portion 2120. The connection portion 2120 extends from thebody portion 2122 and has an external periphery 2128. The externalperiphery 2128 of the connection portion 2120 may be positioned withinthe internal periphery 2134 of the sleeve portion 2116 of the stemcomponent 2112.

The external periphery 2128 of the connection portion 2120 may include aconnection resection ring 2139. The connection resection ring 2139 maybe used for alignment with the resected plane 11 of the long bone 6. Theexternal periphery 2128 of the connection portion 2120 is spacedinwardly from the external periphery 2158 of the sleeve portion 2116 ofthe stem component 2112 when the first joint component 2118 is fixedlyconnected to the stem component 2112 so that the joint component 2018may be removed from the long bone 6 without disturbing the fixation ofthe stem component 2112 to the long bone 6.

As shown in FIG. 26, the connection portion 2120 of the first jointcomponent 2118 may be adapted to be removably fixedly connected to thestem component 2112. Further the prosthesis 2101 may include a secondjoint component 2160 removably fixedly connectable to the stemcomponent. The first joint component 2118 and the second joint component2160 may, as shown, be interchangeably connected to the stem component2112 while the stem component 2112 is implanted in the cavity 2 of thelong bone 6.

As shown in FIG. 26, the connection portion 2120 of the first jointcomponent 2118 may be adapted to fit within the internal periphery 2134of the stem component 2112.

As shown in FIG. 26, a portion 2136 of the external periphery 2158 ofthe stem component 2112 may be generally planar. Further a portion 2140of the external periphery 2128 of the first joint component 2118 may begenerally planar. The portion 2136 of the external periphery 2158 of thestem component 2112 and the portion 2140 of the external periphery 2128of the first joint component 2118 may, as shown, be adapted for contactwith each other.

The first joint component 2118, as shown in FIG. 26, may include afeature 2148 for cooperation with a connector 2144 to connect the firstjoint component 2118 to the stem component 2112. The feature 2148 may bein the form of an aperture 2148 for passing the connector 2144 throughthe first joint component 2118. For example, the aperture 2148 may be acylindrical aperture.

The first joint component 2118 as shown in FIG. 26 may include aprotrusion 2146. Alternatively, the joint component may include anaperture (not shown). The protrusion 2146 may, as shown, be tapered.

It should be appreciated that first joint component 2118 may be in theform of a hip stem neck 2118.

The first joint component 2118 and the second joint component 2160 may,as shown in FIG. 26, be interchangeably connectable to the stemcomponent 2112. Thereby the stem component 2112 can receive jointcomponents of varying heights, offsets and degrees of version.

According to the present invention and as shown in FIG. 27, a stemcomponent 2212 for use with a joint component 2218 having a body portion2220 and a connection portion 2222 in performing joint arthroplasty isprovided. The connection portion 2222 of the joint component 2218 has anexternal periphery 2278. At least a portion of the stem component 2212may be fitted to cavity 2 in canal 4 of a long bone 6. The stemcomponent 2212 includes a canal portion 2214 having a first end 2215 forinsertion into the cavity and an opposed second end 2217.

The stem component 2212 also includes a sleeve portion 2226 extendingfrom the second end 2217 of the canal portion 2214. The sleeve portion2226 has an internal periphery 2219 that forms an internal cavity 2232.The sleeve portion 2226 has an external periphery 2221. The canalportion 2214 and/or the sleeve portion 2226 may be in removable fixedengagement with the joint component 2218. At least a portion of theexternal periphery 2221 of the sleeve portion 2226 may be fitted to thecavity 2 of the long bone 6. At least a portion of the externalperiphery 2278 of the connection portion 2222 of the joint component2218 may be fitted into the internal cavity 2232 of the sleeve portion2226, so that the external periphery 2278 of the connection portion 2222of the joint component 2218 is spaced inwardly from the externalperiphery 2221 of the sleeve portion 2226 of the stem component 2212when the joint component 2218 is fixedly connected to the stem component2212 so that the joint component 2218 may be removed from the long bone6 without disturbing the fixation of the stem component 2212 to the longbone 6.

As shown in FIG. 27, the stem component 2212 may be configured with aportion 2236 of the external periphery 2221 of the stem component 2212being generally planar. Further a portion 2240 of the external periphery2278 of the joint component 2218 may as shown be generally planar. Theportion 2236 of the external periphery 2221 of the stem component 2212and the portion 2240 of the external periphery 2278 of the jointcomponent 2218 as shown in FIG. 27 it should be appreciated are adaptedfor contact with each other.

The stem component 2212 may as shown in FIG. 27 include a feature 2252for cooperation with a connector 2244 to connect the stem component 2212to the joint component 2218. As shown in FIG. 27, the feature 2252 maybe in the form of a threaded cavity or in the form of a cylindricalcavity which have been formed in the stem component 2212.

Further and as shown in FIG. 27, the stem component 2212 may include aconnection feature 2248 for connection with the joint component 2218.The connection feature 2248 may, as shown, be in the form of a cavity2248 formed in the stem component 2212. Alternatively, the connectionfeature (not shown) may be in the form of a cavity. The connectionfeature 2248 may be tapered.

The stem component 2212 may be in the form of a hip stem 2212.Alternatively the stem component 2212 may be in the form of a tibialimplant or a shoulder stem FIGS. 17 and 18 respectively. It should beappreciated that the stem component 2212 may be any component forcooperation with a long bone 6.

The sleeve portion 2226 of the stem component 2212 may define a wallthickness WT thereof. The wall thickness WT may, as shown, be generallyuniform about the external periphery 2221 of the sleeve portion 2226 ina plane normal to longitudinal axis 2223 of the joint component 2218.The external periphery 2278 of the connection portion 2222 of the jointcomponent 2218 may, as shown, be adapted to closely conform to thesleeve portion 2226 of the stem component 2212.

It should be appreciated that the stem component 2212 may beinterchangeably connected to a variety of joint components 2218 withsimilar or identical connectors, so that the stem component 2212 canreceive joint components of varying heights, offsets and degrees ofversion.

Although the present invention and its advantages have been described indetail, it should be understood that various changes, substitutions, andalterations can be made therein without departing from the spirit andscope of the present invention as defined by the appended claims.

1. A stem component for use with a joint component having a body portionand a connection portion in performing joint arthroplasty, theconnection portion of the joint component defining an external peripherythereof, at least a portion of the stem component to be fitted to acavity in a canal of a long bone, said stem component comprising: acanal portion, said canal portion defining a first end thereof forinsertion into the cavity and an opposed second end; and a sleeveportion extending from the second end of said canal portion, said sleeveportion having an internal periphery thereof defining an internal cavitythereof, said sleeve portion also having an external periphery thereof,at least one of said canal portion and said sleeve portion adapted forremovable fixed engagement with the joint component, at least a portionof the external periphery of said sleeve portion adapted to be fitted tothe cavity of the long bone, at least a portion of the externalperiphery of the connection portion of the joint component to be fittedinto the internal cavity of said sleeve portion, so that the externalperiphery of the connection portion of the joint component is spacedinwardly from the external periphery of said sleeve portion of the stemcomponent when the joint component is fixedly connected to the stemcomponent so that the joint component may be removed from the long bonewithout disturbing the fixation of the stem component to the long bone.2. The stem component of claim 1: wherein a portion of the externalperiphery of said stem component is generally planar; and wherein aportion of the external periphery of the joint component is generallyplanar, the portion of the external periphery of said stem component andthe portion of the external periphery of the joint component beingadapted for contact with each other.
 3. The stem component of claim 1,further comprising a feature for cooperation with a connector to connectsaid stem component to the joint component.
 4. The stem component ofclaim 3, wherein said feature comprises a threaded cavity formed in saidstem component.
 5. The stem component of claim 3, wherein said featurecomprises a cylindrical cavity formed in said stem component.
 6. Thestem component of claim 1: wherein said stem component comprises aconnection feature for connection with the joint component; and whereinsaid connection feature comprises one of a protrusion or a cavity formedin said stem component.
 7. The stem component of claim 6, wherein saidconnection feature is tapered.
 8. The stem component of claim 1, whereinsaid stem component comprises a hip stem.
 9. The stem component of claim1: wherein the joint component defines a longitudinal axis thereof; andwherein said sleeve portion defines a wall thickness thereof, the wallthickness being generally uniform about the outer periphery of saidsleeve portion in a plane normal to the longitudinal axis of the jointcomponent, the external periphery of the body portion of the jointcomponent adapted to closely conform to the sleeve portion of said stemcomponent.
 10. The stem component of claim 1, wherein said stemcomponent is interchangeably connectable to the joint component, so thatsaid stem component can receive joint components of varying heights,offsets and degrees of version.
 11. A joint component for use with astem component having a canal portion and a sleeve portion in performingjoint arthroplasty, the sleeve portion of the stem component defining aninternal periphery thereof and an external periphery thereof, at least aportion of the external periphery of the sleeve portion of the stemcomponent to be fitted to a cavity in the canal of a long bone, thecavity extending from a resected plane of the long bone, said jointcomponent comprising: a body portion; and a connection portion extendingfrom said body portion, said connection portion of said joint componentdefining an external periphery thereof, the external periphery of saidconnection portion adapted to be positioned within the internalperiphery of the sleeve portion of the stem component, the externalperiphery of said connection portion defining a connection resectionring thereof, the connection resection ring adapted for alignment withthe resected plane of the long bone, the external periphery of saidconnection portion be spaced inwardly from the external periphery of thesleeve portion of the stem component when said joint component isfixedly connected to the stem component so that said joint component maybe removed from the long bone without disturbing the fixation of thestem component to the long bone.
 12. The joint component of claim 11:wherein said connection portion of said joint component is adapted to beremovably fixedly connectable to the stem component; and furthercomprising a second joint component removably fixedly connectable to thestem component, whereby the first mentioned joint component and thesecond joint component are interchangeably connected to the stemcomponent while the stem component is implanted in the cavity of thelong bone.
 13. The joint component of claim 11, wherein said connectionportion of said joint component is adapted to fit within the internalperiphery of the stem component.
 14. The joint component of claim 11:wherein a portion of the external periphery of the stem component isgenerally planar; and wherein a portion of the external periphery ofsaid joint component is generally planar, the portion of the externalperiphery of the stem component and the portion of the externalperiphery of said joint component being adapted for contact with eachother.
 15. The joint component of claim 11, further comprising a featurefor cooperation with a connector to connect said joint component to thestem component.
 16. The joint component of claim 15, wherein saidfeature comprises an aperture for passage of the connector therethrough.17. The joint component of claim 16, wherein said aperture comprises acylindrical aperture.
 18. The joint component of claim 11, wherein saidjoint component comprises one of a protrusion or an aperture.
 19. Thejoint component of claim 18, wherein the protrusion is tapered.
 20. Thejoint component of claim 11, wherein said joint component comprises ahip stem neck.
 21. The joint component of claim 11, wherein said jointcomponent is interchangeably connectable to the stem component, so thatthe stem component can receive joint components of varying heights,offsets and degrees of version.
 22. A kit for use in performing jointarthroplasty, said kit comprising: an orthopaedic stem trial for use inperforming joint arthroplasty, said trial to be fitted to a cavity inthe canal of a long bone and to assist in performing a trial reductionin performing joint arthroplasty, said orthopaedic stem trial includinga canal component defining a external periphery thereof, at least aportion of said canal component to be fitted to the cavity in the canalof the long bone, the canal component including a canal portion, thecanal portion defining a first end thereof for insertion into the cavityand an opposed second end, the canal component further including asleeve portion extending from the second end of said canal portion, thesleeve portion having an internal periphery thereof defining an internalcavity thereof, the sleeve portion also having an external peripherythereof, said orthopaedic stem trial also including a joint componentremovably connectable to the canal component, the joint component havinga body portion and a connection portion, the connection portion of thejoint component defining an external periphery thereof, at least aportion of the external periphery of the sleeve portion adapted to befitted to the cavity of the long bone, at least a portion of theexternal periphery of the connection portion of the joint component tobe fitted into the internal cavity of the sleeve portion, so that theexternal periphery of the connection portion of the joint component isspaced inwardly from the external periphery of the sleeve portion of thestem component when the joint component is fixedly connected to the stemcomponent so that the joint component may be removed from the long bonewithout disturbing the fixation of the stem component to the long bone;and an orthopaedic stem implant for use in performing jointarthroplasty, said implant to be fitted to a cavity in the canal of along bone to perform a joint arthroplasty, said orthopaedic stem implantincluding a canal component defining a external periphery thereof, atleast a portion of the canal component to be fitted to the cavity in thecanal of the long bone, the canal component including a canal portion,the canal portion defining a first end thereof for insertion into thecavity and an opposed second end, the canal component further includinga sleeve portion extending from the second end of the canal portion, thesleeve portion having an internal periphery thereof defining an internalcavity thereof, the sleeve portion also having an external peripherythereof, said orthopaedic stem implant also including a joint componentremovably connectable to the canal component, the joint component havinga body portion and a connection portion, the connection portion of thejoint component defining an external periphery thereof, at least aportion of the external periphery of the sleeve portion adapted to befitted to the cavity of the long bone, at least a portion of theexternal periphery of the connection portion of the joint component tobe fitted into the internal cavity of the sleeve portion, so that theexternal periphery of the connection portion of the joint component isspaced inwardly from the external periphery of said sleeve portion ofthe stem component when the joint component is fixedly connected to thestem component so that the joint component may be removed from the longbone without disturbing the fixation of the stem component to the longbone.